@article{ author = {Abdi, Jahangir}, title = {}, abstract ={}, Keywords = {}, volume = {2}, Number = {1}, pages = {0-0}, publisher = {}, url = {http://newresearch.medilam.ac.ir/article-1-432-en.html}, eprint = {}, journal = {Technology and Research Information System}, issn = {}, eissn = {}, year = {2019} } @article{ author = {Mirzaei, As}, title = {}, abstract ={}, Keywords = {}, volume = {2}, Number = {1}, pages = {0-0}, publisher = {}, url = {http://newresearch.medilam.ac.ir/article-1-426-en.html}, eprint = {}, journal = {Technology and Research Information System}, issn = {}, eissn = {}, year = {2019} } @article{ author = {Azami, Sanaz and Mozafari, Mosayeb and Badakhsh, Behz}, title = {Effectiveness of self-efficacy enhancing intervention on self-management of patients with type 2 diabetes in shahid Mostafa Khomeini Hpspital, Ilam, Iran, year 2015-2016}, abstract ={The theory of self-efficacy is the central concept of social cognitive theory with emphasis on the constructs of efficacy expectation, outcome expectation. Efficacy expectation is defined as the person’s confidence to carry out a specific behavior. Outcome expectation is beliefs that carrying out a specific behavior will lead to a specific outcome. While the benefit of measuring outcome expectations has been established, there has been no large scale within the Iranian context. The purpose of this study is to examine the reliability-validity of the Persian version of the Perceived Therapeutic Efficacy Scale (PTES). Methods: This study was conducted among 160 patients with type 2 diabetes mellitus (T2DM) using a self-administered instrument measuring outcome expectation. We used a methodological study design to assess the validity and reliability of the translated Persian version of the instrument. Results: The findings of the present study support the uni-dimensionality of the Persian version of the instrument. The 10 items of the scale account for 73.54% of the total variance and the un-rotated factor loadings ranged from 0.66 to 0.93. Moreover, this study offers support for convergent validity and internal consistency of the scale. Conclusion: Our study demonstrated good convergent validity, factor structure and internal consistency in a sample of 160 Iranian adults with T2DM. Therefore, the Persian version of the scale is a valid and reliable instrument and can be used in research and clinical settings.}, Keywords = {Confirmatory factor analysis, Convergent validity, Exploratory factor analysis, Outcome expectation scale, Persian version of outcome expectation scale Cite this article as: Azami G, Lam SK, Shariff-Ghazali S, Said SM, Aazami S, Mozafari M, et al. Validat}, volume = {2}, Number = {1}, pages = {0-0}, publisher = {}, url = {http://newresearch.medilam.ac.ir/article-1-425-en.html}, eprint = {}, journal = {Technology and Research Information System}, issn = {}, eissn = {}, year = {2019} } @article{ author = {bastami, tahereh and Sayehmiri, Kourosh}, title = {Prevalence of burnout among nurses: a systematic review and meta-analysis}, abstract ={The main part of any society is its working population. These people who are employed in different organizations face problems according to the atmosphere of the organization, the type of job and their duties. One of the concepts that has attracted the attention of organizational industrial psychologists in recent years is exhaustion, lethargy, lethargy, laziness and lethargy of the job manager, which is called burnout. Burnout is a negative change in a person's attitude, mood and behavior in the face of job stress.One of the factors affecting the reduction of job productivity of employees is the level of mental health of employees. In other words, burnout can reduce the level of efficiency of the organization as a deterrent and therefore the organization suffers a lot of losses. The extent of their burnout can be considered as an introduction to the efforts to relieve people from burnout in the organization.}, Keywords = {Prevalence + burnout among nurses+ a systematic review and meta-analysis}, volume = {2}, Number = {1}, pages = {0-0}, publisher = {}, url = {http://newresearch.medilam.ac.ir/article-1-428-en.html}, eprint = {http://newresearch.medilam.ac.ir/article-1-428-en.docx}, journal = {Technology and Research Information System}, issn = {}, eissn = {}, year = {2019} } @article{ author = {Pakzad, Iraj and Kazemian, Hossei}, title = {Identification of Carbapenemase genes and evaluation of their prevalence among E.coli and Klebsiella pneumoniae Isolated from patients who admitted to Ilam hospitals by phenotypic and genotypic method}, abstract ={Abstract Objectives: Drug resistance among gram-negative bacteria is a worldwide challenge. Due to the importance of drugresistant Klebsiella pneumoniae and Escherichia coli strains in hospital-acquired infections, we aimed to determine the phenotypic and genotypic characteristics of ESBL-, AmpC-, and carbapenemase-producing isolates obtained from hospitalized patients in Tehran and Ilam (Iran). Materials and Methods: In total, 90 K. pneumoniae isolates and 65 E. coli isolates were collected from various infections. Phenotypic identification of bacterial isolates was performed using standard methods. Phenotypic screening of ESBL, AmpC, and carbapenemase enzymes was carried out. Detection of ESBL, AmpC, and carbapenemase genes was also performed by the PCR method. Results: Phenotypic detection tests showed that 36 (40%) K. pneumoniae and 23 (35.4%) E. coli isolates were ESBL producers. Moreover, 18 (20%) and 6 (9.2%) K. pneumoniae and E. coli isolates were AmpC producers, respectively. Modified Hodge test results indicated that 39 H.K. and H.H. contributed equally to this work as first authors. This is an Open Access article licensed under the Creative Commons Attribution-NonCommercial-4.0 International License (CC BY-NC) (http://www.karger.com/Services/OpenAccessLicense), applicable to the online version of the article only. Usage and distribution for commercial purposes requires written permission. 2 Med Princ Pract Kazemian et al. DOI: 10.1159/000500311 (43.3%) K. pneumoniae and 18 (27.7%) E. coli isolates produced carbapenemase. Molecular tests showed that 40% of K. pneumoniae and 36.9% of E. coli isolates were ESBL positive. AmpC was detected in 24.4 and 13.8% of K. pneumoniae and E. coli isolates. Carbapenemase was detected in 34 (37.8%) K. pneumoniae and 13 (20%) E. coli isolates. Conclusion: In this study, 3 K. pneumoniae isolates simultaneously carried ESBL, AmpC, and carbapenemase genes. Upto- date strategies such as combination therapy or utilization of new antimicrobial agents might help to combat such drug-resistant organisms. © 2019 The Author(s) Published by S. Karger AG, Basel Introduction Drug resistance in gram-negative bacteria is a worldwide challenge [1]. Major resistance to gram-negative pathogens is related to Enterobacteriaceae, Acinetobacter baumannii, and Pseudomonas aeruginosa [2]. In the Enterobacteriaceae family, Klebsiella pneumoniae and Escherichia coli have notable drug resistance. Also, they are the common cause of hospital- and community-acquired infections [3, 4]. The wide distribution of extended-spectrum β-lactamases (ESBLs) amongst Enterobacteriaceae has been attributed to the over- or misuse of these antibiotics [5]. ESBLs are able to hydrolyze various types of β-lactam antibiotics, including cephalosporins and monobactams. Therefore, treating infections caused by ESBL-producing bacteria has become a complicated issue [5, 6]. Dissemination of hospital-acquired infections can be prevented via early detection of infections caused by such microorganisms [7]. Carbapenems have been considered as the treatment of choice for ESBL-producing gram-negative bacterial infections. Carbapenemase-producing strains cause serious infections in hospitalized patients and are associated with mortality [8]; hence, the use of molecular techniques could be helpful in accurately diagnosing infections caused by ESBL- and carbapenemase-producing organisms. Drug-resistant strains of K. pneumoniae and E. coli in hospital-acquired infections are important [9]; thus, the aim of the present study was to determine the phenotypic and genotypic characterization of ESBL-, AmpC-, and carbapenemase-producing isolates of K. pneumoniae and E. coli obtained from hospital-associated infections in Tehran and Ilam (Iran). Materials and Methods Bacterial Strains A total of 90 K. pneumoniae and 65 E. coli isolates were obtained from various infections of hospitalized patients between April 2016 and March 2017 in Tehran and Ilam. Phenotypic and biochemical identification of bacterial isolates was performed according to standard methods [10]. Phenotypic Screening of ESBL, AmpC, and Carbapenemase Enzymes All isolates were initially screened for ESBL production by a combined disk method according to the guidelines of the Clinical Laboratory Standards Institute (CLSI) [11]. Briefly, susceptibility to cefotaxime (30 μg), cefotaxime/clavulanate (30/10 μg), ceftazidime (30 μg), and ceftazidime/clavulanate (30/10 μg) (Mast Co., UK) was determined on Müller-Hinton agar (Merck Co, Germany). ESBL-producing strains were recognized by an at least 5-mm increase in zone diameter around cefotaxime/clavulanate and ceftazidime/clavulanate disks in comparison with disks without clavulanic acid. E. coli ATCC 35218 was used as the control strain [11]. Cefoxitin disks (30 μg) were used to screen AmpC-producing isolates according to CLSI recommendations [11]. A cefoxitincloxacillin double-disk synergy test was carried out to confirm AmpC production, as previously described [12]. The modified Hodge test (MHT) was performed to screen carbapenemase- producing isolates [11]. K. pneumoniae ATCC BAA- 1705 and BAA-1706 were used as MHT-positive and -negative controls [11]. Detection of ESBL-, AmpC-, and Carbapenemase-Related Genes Polymerase chain reaction was performed using specific primers to detect genes encoding ESBLs (blaTEM, blaSHV, blaCTX-M, and blaPER), AmpC (blaACC, blaDHA, blaEBC, blaFOX, blaMOX, and blaCIT), and carbapenemase (blaIMP, blaVIM, blaNDM, blaKPC, and blaOXA-48-like), as previously described [13–17]. The products were separated by electrophoresis in 1% agarose gel with 1× TBE (Tris/ borate/EDTA) buffer, stained with safe stain load dye (CinnaGen Co., Tehran, Iran) and visualized under ultraviolet illumination. Statistical Analysis The distribution of resistance genes among resistant and susceptible isolates was calculated using χ2 and Fisher’s exact tests for each gene. p values ≤0.05 were considered to be statistically significant.}, Keywords = {Klebsiella pneumoniae · Escherichia coli · ESBLs · AmpC · Carbapenemase}, volume = {2}, Number = {1}, pages = {0-0}, publisher = {}, url = {http://newresearch.medilam.ac.ir/article-1-434-en.html}, eprint = {http://newresearch.medilam.ac.ir/article-1-434-en.doc}, journal = {Technology and Research Information System}, issn = {}, eissn = {}, year = {2019} } @article{ author = {Abdalmahmoodabadi, Khadijeh}, title = {Association of mast cells and macrophage density with tumor angiogenesis in various type of oral and skin squamous cell carcinomas}, abstract ={Mast cells and microvessel play an important role in tumor development and progression through angiogenesis. Because of the more aggressive potential and poor prognosis of oral squamous cell carcinoma (OSCC) compared to cutaneous squamous cell carcinoma (CSCC), the aim of the present study was to compare of density of mast cells and microvessel between in oral and cutaneous squamous cell carcinoma. In this study cross-sectional study, we performed an immuno histochemical analysis in 100 paraffin blocks that included 40 cases of OSCC and 40 CSCC and 20 cases of normal skin and normal oral mucosa. Mast cells and microvascular density were stained by mast cell tryptase and immunohistochemistry assay using CD34. Statistical analyses were performed in SPSS 16 software. There was a significant statistical correlation (*P<0.05) between mast cell concentration and microvascular density in OSCC and CSCC compared to control groups. In OSCC the mast cell concentration and microvascular density were significantly higher (*P<0.05) compared with the CSCC. Therefore, according findings present study, mast cell concentration and microvascular density may be used as a factor for detecting the progression, malignant potential and invasion of OSCC compared to CSCC.Mast cells and microvessel play an important role in tumor development and progression through angiogenesis. Because of the more aggressive potential and poor prognosis of oral squamous cell carcinoma (OSCC) compared to cutaneous squamous cell carcinoma (CSCC), the aim of the present study was to compare of density of mast cells and microvessel between in oral and cutaneous squamous cell carcinoma. In this study cross-sectional study, we performed an immuno histochemical analysis in 100 paraffin blocks that included 40 cases of OSCC and 40 CSCC and 20 cases of normal skin and normal oral mucosa. Mast cells and microvascular density were stained by mast cell tryptase and immunohistochemistry assay using CD34. Statistical analyses were performed in SPSS 16 software. There was a significant statistical correlation (*P<0.05) between mast cell concentration and microvascular density in OSCC and CSCC compared to control groups. In OSCC the mast cell concentration and microvascular density were significantly higher (*P<0.05) compared with the CSCC. Therefore, according findings present study, mast cell concentration and microvascular density may be used as a factor for detecting the progression, malignant potential and invasion of OSCC compared to CSCC.Mast cells and microvessel play an important role in tumor development and progression through angiogenesis. Because of the more aggressive potential and poor prognosis of oral squamous cell carcinoma (OSCC) compared to cutaneous squamous cell carcinoma (CSCC), the aim of the present study was to compare of density of mast cells and microvessel between in oral and cutaneous squamous cell carcinoma. In this study cross-sectional study, we performed an immuno histochemical analysis in 100 paraffin blocks that included 40 cases of OSCC and 40 CSCC and 20 cases of normal skin and normal oral mucosa. Mast cells and microvascular density were stained by mast cell tryptase and immunohistochemistry assay using CD34. Statistical analyses were performed in SPSS 16 software. There was a significant statistical correlation (*P<0.05) between mast cell concentration and microvascular density in OSCC and CSCC compared to control groups. In OSCC the mast cell concentration and microvascular density were significantly higher (*P<0.05) compared with the CSCC. Therefore, according findings present study, mast cell concentration and microvascular density may be used as a factor for detecting the progression, malignant potential and invasion of OSCC compared to CSCC.Mast cells and microvessel play an important role in tumor development and progression through angiogenesis. Because of the more aggressive potential and poor prognosis of oral squamous cell carcinoma (OSCC) compared to cutaneous squamous cell carcinoma (CSCC), the aim of the present study was to compare of density of mast cells and microvessel between in oral and cutaneous squamous cell carcinoma. In this study cross-sectional study, we performed an immuno histochemical analysis in 100 paraffin blocks that included 40 cases of OSCC and 40 CSCC and 20 cases of normal skin and normal oral mucosa. Mast cells and microvascular density were stained by mast cell tryptase and immunohistochemistry assay using CD34. Statistical analyses were performed in SPSS 16 software. There was a significant statistical correlation (*P<0.05) between mast cell concentration and microvascular density in OSCC and CSCC compared to control groups. In OSCC the mast cell concentration and microvascular density were significantly higher (*P<0.05) compared with the CSCC. Therefore, according findings present study, mast cell concentration and microvascular density may be used as a factor for detecting the progression, malignant potential and invasion of OSCC compared to CSCC.Mast cells and microvessel play an important role in tumor development and progression through angiogenesis. Because of the more aggressive potential and poor prognosis of oral squamous cell carcinoma (OSCC) compared to cutaneous squamous cell carcinoma (CSCC), the aim of the present study was to compare of density of mast cells and microvessel between in oral and cutaneous squamous cell carcinoma. In this study cross-sectional study, we performed an immuno histochemical analysis in 100 paraffin blocks that included 40 cases of OSCC and 40 CSCC and 20 cases of normal skin and normal oral mucosa. Mast cells and microvascular density were stained by mast cell tryptase and immunohistochemistry assay using CD34. Statistical analyses were performed in SPSS 16 software. There was a significant statistical correlation (*P<0.05) between mast cell concentration and microvascular density in OSCC and CSCC compared to control groups. In OSCC the mast cell concentration and microvascular density were significantly higher (*P<0.05) compared with the CSCC. Therefore, according findings present study, mast cell concentration and microvascular density may be used as a factor for detecting the progression, malignant potential and invasion of OSCC compared to CSCC.Mast cells and microvessel play an important role in tumor development and progression through angiogenesis. Because of the more aggressive potential and poor prognosis of oral squamous cell carcinoma (OSCC) compared to cutaneous squamous cell carcinoma (CSCC), the aim of the present study was to compare of density of mast cells and microvessel between in oral and cutaneous squamous cell carcinoma. In this study cross-sectional study, we performed an immuno histochemical analysis in 100 paraffin blocks that included 40 cases of OSCC and 40 CSCC and 20 cases of normal skin and normal oral mucosa. Mast cells and microvascular density were stained by mast cell tryptase and immunohistochemistry assay using CD34. Statistical analyses were performed in SPSS 16 software. There was a significant statistical correlation (*P<0.05) between mast cell concentration and microvascular density in OSCC and CSCC compared to control groups. In OSCC the mast cell concentration and microvascular density were significantly higher (*P<0.05) compared with the CSCC. Therefore, according findings present study, mast cell concentration and microvascular density may be used as a factor for detecting the progression, malignant potential and invasion of OSCC compared to CSCC.Mast cells and microvessel play an important role in tumor development and progression through angiogenesis. Because of the more aggressive potential and poor prognosis of oral squamous cell carcinoma (OSCC) compared to cutaneous squamous cell carcinoma (CSCC), the aim of the present study was to compare of density of mast cells and microvessel between in oral and cutaneous squamous cell carcinoma. In this study cross-sectional study, we performed an immuno histochemical analysis in 100 paraffin blocks that included 40 cases of OSCC and 40 CSCC and 20 cases of normal skin and normal oral mucosa. Mast cells and microvascular density were stained by mast cell tryptase and immunohistochemistry assay using CD34. Statistical analyses were performed in SPSS 16 software. There was a significant statistical correlation (*P<0.05) between mast cell concentration and microvascular density in OSCC and CSCC compared to control groups. In OSCC the mast cell concentration and microvascular density were significantly higher (*P<0.05) compared with the CSCC. Therefore, according findings present study, mast cell concentration and microvascular density may be used as a factor for detecting the progression, malignant potential and invasion of OSCC compared to CSCC.Mast cells and microvessel play an important role in tumor development and progression through angiogenesis. Because of the more aggressive potential and poor prognosis of oral squamous cell carcinoma (OSCC) compared to cutaneous squamous cell carcinoma (CSCC), the aim of the present study was to compare of density of mast cells and microvessel between in oral and cutaneous squamous cell carcinoma. In this study cross-sectional study, we performed an immuno histochemical analysis in 100 paraffin blocks that included 40 cases of OSCC and 40 CSCC and 20 cases of normal skin and normal oral mucosa. Mast cells and microvascular density were stained by mast cell tryptase and immunohistochemistry assay using CD34. Statistical analyses were performed in SPSS 16 software. There was a significant statistical correlation (*P<0.05) between mast cell concentration and microvascular density in OSCC and CSCC compared to control groups. In OSCC the mast cell concentration and microvascular density were significantly higher (*P<0.05) compared with the CSCC. Therefore, according findings present study, mast cell concentration and microvascular density may be used as a factor for detecting the progression, malignant potential and invasion of OSCC compared to CSCC.Mast cells and microvessel play an important role in tumor development and progression through angiogenesis. Because of the more aggressive potential and poor prognosis of oral squamous cell carcinoma (OSCC) compared to cutaneous squamous cell carcinoma (CSCC), the aim of the present study was to compare of density of mast cells and microvessel between in oral and cutaneous squamous cell carcinoma. In this study cross-sectional study, we performed an immuno histochemical analysis in 100 paraffin blocks that included 40 cases of OSCC and 40 CSCC and 20 cases of normal skin and normal oral mucosa. Mast cells and microvascular density were stained by mast cell tryptase and immunohistochemistry assay using CD34. Statistical analyses were performed in SPSS 16 software. There was a significant statistical correlation (*P<0.05) between mast cell concentration and microvascular density in OSCC and CSCC compared to control groups. In OSCC the mast cell concentration and microvascular density were significantly higher (*P<0.05) compared with the CSCC. Therefore, according findings present study, mast cell concentration and microvascular density may be used as a factor for detecting the progression, malignant potential and invasion of OSCC compared to CSCC.Mast cells and microvessel play an important role in tumor development and progression through angiogenesis. Because of the more aggressive potential and poor prognosis of oral squamous cell carcinoma (OSCC) compared to cutaneous squamous cell carcinoma (CSCC), the aim of the present study was to compare of density of mast cells and microvessel between in oral and cutaneous squamous cell carcinoma. In this study cross-sectional study, we performed an immuno histochemical analysis in 100 paraffin blocks that included 40 cases of OSCC and 40 CSCC and 20 cases of normal skin and normal oral mucosa. Mast cells and microvascular density were stained by mast cell tryptase and immunohistochemistry assay using CD34. Statistical analyses were performed in SPSS 16 software. There was a significant statistical correlation (*P<0.05) between mast cell concentration and microvascular density in OSCC and CSCC compared to control groups. In OSCC the mast cell concentration and microvascular density were significantly higher (*P<0.05) compared with the CSCC. Therefore, according findings present study, mast cell concentration and microvascular density may be used as a factor for detecting the progression, malignant potential and invasion of OSCC compared to CSCC.Mast cells and microvessel play an important role in tumor development and progression through angiogenesis. Because of the more aggressive potential and poor prognosis of oral squamous cell carcinoma (OSCC) compared to cutaneous squamous cell carcinoma (CSCC), the aim of the present study was to compare of density of mast cells and microvessel between in oral and cutaneous squamous cell carcinoma. In this study cross-sectional study, we performed an immuno histochemical analysis in 100 paraffin blocks that included 40 cases of OSCC and 40 CSCC and 20 cases of normal skin and normal oral mucosa. Mast cells and microvascular density were stained by mast cell tryptase and immunohistochemistry assay using CD34. Statistical analyses were performed in SPSS 16 software. There was a significant statistical correlation (*P<0.05) between mast cell concentration and microvascular density in OSCC and CSCC compared to control groups. In OSCC the mast cell concentration and microvascular density were significantly higher (*P<0.05) compared with the CSCC. Therefore, according findings present study, mast cell concentration and microvascular density may be used as a factor for detecting the progression, malignant potential and invasion of OSCC compared to CSCC.Mast cells and microvessel play an important role in tumor development and progression through angiogenesis. Because of the more aggressive potential and poor prognosis of oral squamous cell carcinoma (OSCC) compared to cutaneous squamous cell carcinoma (CSCC), the aim of the present study was to compare of density of mast cells and microvessel between in oral and cutaneous squamous cell carcinoma. In this study cross-sectional study, we performed an immuno histochemical analysis in 100 paraffin blocks that included 40 cases of OSCC and 40 CSCC and 20 cases of normal skin and normal oral mucosa. Mast cells and microvascular density were stained by mast cell tryptase and immunohistochemistry assay using CD34. Statistical analyses were performed in SPSS 16 software. There was a significant statistical correlation (*P<0.05) between mast cell concentration and microvascular density in OSCC and CSCC compared to control groups. In OSCC the mast cell concentration and microvascular density were significantly higher (*P<0.05) compared with the CSCC. Therefore, according findings present study, mast cell concentration and microvascular density may be used as a factor for detecting the progression, malignant potential and invasion of OSCC compared to CSCC.Mast cells and microvessel play an important role in tumor development and progression through angiogenesis. Because of the more aggressive potential and poor prognosis of oral squamous cell carcinoma (OSCC) compared to cutaneous squamous cell carcinoma (CSCC), the aim of the present study was to compare of density of mast cells and microvessel between in oral and cutaneous squamous cell carcinoma. In this study cross-sectional study, we performed an immuno histochemical analysis in 100 paraffin blocks that included 40 cases of OSCC and 40 CSCC and 20 cases of normal skin and normal oral mucosa. Mast cells and microvascular density were stained by mast cell tryptase and immunohistochemistry assay using CD34. Statistical analyses were performed in SPSS 16 software. There was a significant statistical correlation (*P<0.05) between mast cell concentration and microvascular density in OSCC and CSCC compared to control groups. In OSCC the mast cell concentration and microvascular density were significantly higher (*P<0.05) compared with the CSCC. Therefore, according findings present study, mast cell concentration and microvascular density may be used as a factor for detecting the progression, malignant potential and invasion of OSCC compared to CSCC.Mast cells and microvessel play an important role in tumor development and progression through angiogenesis. Because of the more aggressive potential and poor prognosis of oral squamous cell carcinoma (OSCC) compared to cutaneous squamous cell carcinoma (CSCC), the aim of the present study was to compare of density of mast cells and microvessel between in oral and cutaneous squamous cell carcinoma. In this study cross-sectional study, we performed an immuno histochemical analysis in 100 paraffin blocks that included 40 cases of OSCC and 40 CSCC and 20 cases of normal skin and normal oral mucosa. Mast cells and microvascular density were stained by mast cell tryptase and immunohistochemistry assay using CD34. Statistical analyses were performed in SPSS 16 software. There was a significant statistical correlation (*P<0.05) between mast cell concentration and microvascular density in OSCC and CSCC compared to control groups. In OSCC the mast cell concentration and microvascular density were significantly higher (*P<0.05) compared with the CSCC. Therefore, according findings present study, mast cell concentration and microvascular density may be used as a factor for detecting the progression, malignant potential and invasion of OSCC compared to CSCC.}, Keywords = {Key words: Squamous cell carcinoma, Mast cell, Microvessel, Prognosis}, volume = {2}, Number = {1}, pages = {0-0}, publisher = {}, url = {http://newresearch.medilam.ac.ir/article-1-435-en.html}, eprint = {http://newresearch.medilam.ac.ir/article-1-435-en.docx}, journal = {Technology and Research Information System}, issn = {}, eissn = {}, year = {2019} } @article{ author = {Bastami, Tahereh and Sayehmiri, Kourosh}, title = {The prevalence of job burnout in Iran: A systematic review and metanalysis}, abstract ={One of the concepts that has attracted the attention of organizational industrial psychologists in recent years is fatigue, lethargy, lethargy, sluggishness and lethargy of the job manager, which is called burnout (1). Part of every person's daily life is spent at work, there are always several factors as a source of stress in the workplace that if a person is not able to cope effectively with these psychological pressures, he will suffer from many physical, psychological and behavioral complications and eventually lead Get into burnout .First, articles related to the prevalence of burnout in Iran are collected by referring to reputable databases inside and outside the country. The collected articles will be between 1974 and 2016. The articles related to the research topic will be collected and the articles that have the criteria for entering the research will be selected and will be reviewed for the final analysis.}, Keywords = {prevalence + job burnout in Iran+A systematic review and metanalysis}, volume = {2}, Number = {1}, pages = {0-0}, publisher = {}, url = {http://newresearch.medilam.ac.ir/article-1-429-en.html}, eprint = {http://newresearch.medilam.ac.ir/article-1-429-en.docx}, journal = {Technology and Research Information System}, issn = {}, eissn = {}, year = {2019} } @article{ author = {Azami, Mil}, title = {Epidemiology of celiac disease in irritable bowel syndrome patients in Iran: a systematic review and met analysis study}, abstract ={Aim: The present study was conducted to evaluate the prevalence, clinical symptoms and pathological findings of celiac disease (CD) in IBS patients in Iran. Background: Several studies show high prevalence of CD in IBS patients, but the results are contradictory Methods: The present study was conducted based on PRISMA protocol. The search was done using national and international online databases including Scopus, PubMed, Science Direct, Cochrane Library, Embase, Web of Science, Google Scholar search engine and Iranian databases. Results: The pooled prevalence of CD in 2367 Iranian IBS patients was estimated to be 6.13% (95%CI: 4.11-6.05). The CD female-to-male ratio was: OR = 1.69 (95%CI: 0.86-3.32, P = 0.127). The serological prevalence of Anti tTG-IgA (11 studies with 2901 IBS patients) and AGA-IgG CD (4 studies with 936 IBS patients) was estimated to be 5.35% (95%CI: 3.60-7.89) and 6.35% (95% CI: 2.05-18.03), respectively. The clinical symptoms of CD among IBS patients included predominant diarrhea (47.78% [95%CI: 22.46-74.43]), predominant constipation (17.34% [95%CI: 9.17-30.35]), and alternative diarrhea and constipation (27.84% [95%CI: 11.57-53.23]). According to pathological findings based on Marsh classification, the prevalence of CD at stages 1, 2 and 3 were 30.89% (95%CI: 13.25-56.68), 36.56% (95%CI: 21.74-54.45) and 52.82% (95% CI: 14.48-88.13), respectively. Conclusion: CD prevalence in Iranian IBS patients is higher than global estimates. It seems that examination of all IBS patients in terms of CD is necessary}, Keywords = {Celiac disease, Irritable bowel syndrome, Meta-Analysis, Iran.}, volume = {2}, Number = {1}, pages = {0-0}, publisher = {}, url = {http://newresearch.medilam.ac.ir/article-1-431-en.html}, eprint = {http://newresearch.medilam.ac.ir/article-1-431-en.docx}, journal = {Technology and Research Information System}, issn = {}, eissn = {}, year = {2019} } @article{ author = {Azami, Milad and Khorshidi, Ali}, title = {Epidemiology of Multiple Sclerosis in Iran: A Systematic Review and Meta-analysis}, abstract ={Background Multiple sclerosis (MS) is one of the most common neurological disorders and is one of the main causes of disability. The prevalence and incidence of MS in Iran is reported to range from 5.3 to 89/ 100,000and 7 to 148.1/ 100,000, respectively. There are no systematic and meta-analysis studies on MS in Iran. Therefore, this study was conducted to investigate the prevalence and incidence of MS in Iran using meta-analysis. Method  A systematic review of the present study focused on MS epidemiology in Iran based on PRISMA guidelines for systematic review and meta-analysis. We searched eight international databases including Scopus, PubMed, Science Direct, Cochrane Library, Web of Science, EMBASE, PsycINFO, Google Scholar search engine and six Persian databases for peer-reviewed studies published without time limit until May 2018. Data were analyzed using Comprehensive meta-analysis ver. 2 software. The review protocol has been registered in PROSPERO with ID: CRD42018114491. Results According to searching on different databases, 39 (15%) articles finalized. The prevalence of MS in Iran  was estimated 29.3/ 100,000 (95%CI: 25.6-33.5) based on random effects model. The prevalence of MS in men and women was estimated to be 16.5/ 100,000 (95%CI: 13.7-23.4) and 44.8/ 100,000 (95%CI: 36.3-61.6), respectively. The incidence of MS in Iran was estimated to be 3.4/ 100,000 (95%CI: 1.8-6.2) based on random effects model. The incidence of MS in men was estimated to be 16.5/ 100,000 (95%CI: 13.7-23.4) and the incidence of MS in women was 44.8/ 100,000 (95%CI: 36.3-61.6). The meta-regression model for prevalence and incidence of MS was significantly higher in terms of year of study (p<0.001). Conclusions The results of this study can provide a general picture of MS epidemiology in Iran. The current meta-analysis showed that the prevalence and incidence of MS in Iran is high and is rising over time.}, Keywords = {Multiple Sclerosis, Iran, Systematic Review, Meta-analysis}, volume = {2}, Number = {1}, pages = {0-0}, publisher = {}, url = {http://newresearch.medilam.ac.ir/article-1-430-en.html}, eprint = {http://newresearch.medilam.ac.ir/article-1-430-en.docx}, journal = {Technology and Research Information System}, issn = {}, eissn = {}, year = {2019} } @article{ author = {Shohani, Masoumeh and Khalighi, Ebrahim and Sayehmiri, Kourosh}, title = {The Effect of Acupuncturing Pericardium 6 (nei guan) on Nausea and Vomiting in Patients under Appendectomy Operation with General Anesthesia}, abstract ={ مقدمه:استفاده از طب سوزنی در حال گسترش است.مطالعات فراوانی از طب سوزنی بر نقطهp6  برای کاهش تهوع و استفراغ بعد از عمل های جراحی استفاده کرده اند،و نتایج متفاوت وگاه متناقضی را گزارش کرده اند.مطالعه حاضر با هدف تعیین تاثیر طب سوزنی نقطه p6 بر تهوع و استفراغ در بیماران پس از عمل جراحی آپاندکتومی انجام شده است. مواد و روشها: این مطالعه به روش کارآزمایی بالینی و دوسوکور برروی 150 بیمار آپاندکتومی شده انجام شد.بیماران به صورت تصادفی به سه گروه مداخله، پلاسبو و کنترل تقسیم شدند. در گروه مداخله نیم ساعت قبل از القای بیهوشی سوزن مخصوص طب سوزنی در نقطه p6 قرار داده شد.در گروه پلاسبو سوزن تلسکوپیک در نقطهp6 تعبیه شد و در گروه کنترل هیچ مداخله ای صورت نگرفت.شدت تهوع و استفراغ بیماران پس از جراحی و تا 24 ساعت بعد توسط پرسشنامه رودزاندازه گیری و ثبت شد. داده ها با استفاده از نرم افزار spss16 و آزمونهای توصیفی و استنباطی(ANOVA  ،  Chi-Square  وkruskal-wallis ) آنالیز شدند. یافته ها: تفاوت آماری معنی داری بین سه گروه از نظر سن، جنس، شاخص توده بدنی و سطح تحصیلات مشاهده نشد. شدت تهوع و استفراغ در گروه مداخله در تمام ساعات پس از جراحی کمتر از گروه پلاسبو و کنترل بود، ولی در طی 6 ساعت اول پس از جراحی از نظر آماری معنا دار نبود(54/0p= ).در ساعات 12-7 بعد از جراحی(00/0p=  )ودر ساعات 24-13پس از جراحی معنی دار بود. (009/0p=)در مجموع 7 بیمار تهوع و استفراغ شدید  داشتند (1نفر گروه مداخله، 2نفر گروه پلاسبو و 4 نفر گروه کنترل). نتیجه گیری: طب سوزنی نقطه p6 تاثیر معنی داری در کاهش تهوع و استفراغ در بیماران تحت عمل آپاندکتومی دارد.  }, Keywords = {Keywords:Acupuncture, appendectomy, nausea, vomiting, P6}, volume = {2}, Number = {1}, pages = {0-0}, publisher = {}, url = {http://newresearch.medilam.ac.ir/article-1-427-en.html}, eprint = {http://newresearch.medilam.ac.ir/article-1-427-en.docx}, journal = {Technology and Research Information System}, issn = {}, eissn = {}, year = {2019} } @article{ author = {Abdalmahmoodabadi, Khadijeh}, title = {: Evaluation of General Dentists Knowledge about Oral Cancer in Ilam-Iran in 2015}, abstract ={Oral cancer is the sixth most common malignant neoplasm and one of the top ten causes of death worldwide. Dentists’ lack of knowledge about the signs and symptoms of oral cancer is an important for diagnosing the oral cancer accurately and at early stages. In this study, we examined the level of dentists’ awareness toward oral cancer in Ilam, Iran. Materials and methods: A total of 98 dentists (65 males and 33 females) with average age of 35.57±7.9 years were invited to take part in the study and respond to suitably designed questionnaires. Data were collected and a possible relationship between age and knowledge score was further analyzed. Results: The maximum awareness score that respondents could attain was 13. The mean score was 8.14 ± 1.8, which was higher than the national average level. The average scores for men and women were 7.58 ± 2.1 and 8.46 ± 1.5, respectively. But, this difference was not statistically significant (P = 0.1).There was no statistically significant relationship between age and knowledge score (P = 0.3, r = -0.11).In addition, knowledge score in different age groups were compared, and there was no significant difference (P = 0.5). Conclusion: Results of this study indicated that dentists’ awareness about oral cancer is higher than average in Ilam; however, the need for educational programs for increasing the level of knowledge about oral cancer is recommended.}, Keywords = {Oral cancer, Knowledge, Dentist}, volume = {2}, Number = {2}, pages = {0-0}, publisher = {}, url = {http://newresearch.medilam.ac.ir/article-1-560-en.html}, eprint = {http://newresearch.medilam.ac.ir/article-1-560-en.docx}, journal = {Technology and Research Information System}, issn = {}, eissn = {}, year = {2019} } @article{ author = {Abdalmahmoodabadi, Khadijeh}, title = {: Evaluation frequency of Basal Cell Carcinoma microscopy and Clinicalvariants in during a period of 10 years}, abstract ={Basal Cell Carcinoma (BCC) is the most common skin neoplasm and the most common type of cancer. Since the incidence of injury is taken into consideration in the pathologic diagnosis, the study of clinical and microscopic views of BCC is of particular importance. The present study aimed at determining the frequency of clinical and microscopic views of BCC in a 10-year period in Ilam province. Materials and methods: This study is descriptive. The study population consisted of all the subjects with BCC in the head and neck area referring to the pathology department of Imam Khomeini hospital in Ilam province in a 10-year period. The data were entered into SPSS 19 software and were analyzed using descriptive statistical methods and Chi-Square test. Results: In the present study, 205 patients were diagnosed with BCC. The maximum and minimum frequency rates of the lesion were detected in the frontal area (9.23%) and neck (8.7%), respectively. The maximum frequency was related to the nodular type (57.1%), while the pigmented variant showed the lowest rate (8.3%). Among the evaluated microscopic variants, maximum views were related to the solid-cystic type (57.1%), while minimum views were related to the pigmented variant (37.3%). There was no significant correlation between the location of the lesion in males and females (p=0.14) or between the location of the lesion and age (p=0.16). Conclusion: The results of this study showed that the nodular type was the most common clinical variant of BCC, while the least common type was the pigmented variant. The most common histological type was the solid-cystic type, while the pigmented variant was the least common type. *Corresponding author: Mostafazadeh S Tel: 0098 9143147428 Email: mostafazadeh_samira@yahoo.com Please cite this paper as: Abdal Kh, Salehinejad J, Mostafazadeh S. Evaluating the frequency of clinical and microscopic views of Basal Cell Carcinoma in a 10-year period. J Res Dentomaxillofac Sci 2016;1(4):39-44 Downloaded from}, Keywords = {Keywords: Skin neoplasms, Basal Cell Carcinoma, Cancer}, volume = {2}, Number = {2}, pages = {0-0}, publisher = {}, url = {http://newresearch.medilam.ac.ir/article-1-559-en.html}, eprint = {http://newresearch.medilam.ac.ir/article-1-559-en.docx}, journal = {Technology and Research Information System}, issn = {}, eissn = {}, year = {2019} } @article{ author = {Abdalmahmoodabadi, Khadijeh}, title = {Prevalence of head and neck tumors during a 10-year period in Ilam}, abstract ={The term "head and neck cancer" refers to a variety of tumors that appear in the throat, larynx, nose, sinuses, and mouth. Cancer that occurs in the mouth can also be considered a type of head and neck cancer. Approximately 52,000 people are diagnosed with head and neck cancer each year. Men are twice as likely as women to get this cancer. About 11,000 people die from the disease each year. Unfortunately, the number of people with this type of cancer has increased in the last 20 years. There are several types of head and neck cancer that are grouped according to the part of the body where the cancer begins. Because the causes of this cancer as well as its diagnosis and treatment can vary depending on the type, the complete information of each type of cancer is presented separately. Malignant tumors of the head and neck may be of epithelial or mesenchymal origin. Types of malignant tumors of the skin and salivary glands in the epithelial group and malignant tumors of muscle, fat, bone, and vascular origin are divided into mesenchymal tumors. Like many types. Cancer, the risk of head and neck cancer may also increase with some behaviors as well as environmental factors, such as smoking, alcohol consumption, malnutrition and vitamin deficiencies, human papillomavirus (HPV) infection, radiation therapy exposure. Especially in the head or neck area. Tvmvrhaybdkhym head and neck Bhdlyldfvrmytyhayaskltalvnqszvhayykhayjadmyknndmannd anesthesia, Ashkaldrblvhmchnynkhtrmtastazvmrg (especially "Drmvardbdkhym) Azahmytkhasybrkhvrdarhstndvnyazmndshnakhtapydmyvlvzhy, Tshkhysbhmvqvdrmansrymybashnd.danshmadrmvrdshyvanvamkhtlftvmvrhavkhsvsyatbalynyanhahmanndsnvjnsvmhlvqvbrayklynysynhadrayjadyktshkhys Bsyarbaarzshast appropriate.}, Keywords = {}, volume = {2}, Number = {2}, pages = {0-0}, publisher = {}, url = {http://newresearch.medilam.ac.ir/article-1-558-en.html}, eprint = {http://newresearch.medilam.ac.ir/article-1-558-en.docx}, journal = {Technology and Research Information System}, issn = {}, eissn = {}, year = {2019} } @article{ author = {Hemmati, Farhad and MousaviMoghadam, SayedMohamm}, title = {Prevalence of osteoporosis in postmenopausal women in Iran: A systematic review and meta-analysis}, abstract ={Osteoporosis is a silent epidemic of the present age. Numerous studies in Iran have reported the prevalence of osteoporosis in postmenopausal women in the range of 8-77%, but there is no general estimate. The aim of this study was to evaluate the prevalence of osteoporosis in Iranian postmenopausal women by meta-analysis. Methods: In this study, search using valid Persian and English keywords in domestic and foreign databases including: IranMedex, SID, Magiran, IranDoc, Medlib, ScienceDirect, Pubmed, Scopus, Cochrane, Embase, Web of Science, Medline and Google search engine. Scholar was performed using the keywords osteoporosis, menopause and Iran in both Persian and English and without time limit until 1396. Heterogeneity of studies was assessed using the I2 index. Data were analyzed using STATA software version 11.1.}, Keywords = {osteoporosis_ postmenopausal women}, volume = {2}, Number = {2}, pages = {0-0}, publisher = {}, url = {http://newresearch.medilam.ac.ir/article-1-557-en.html}, eprint = {http://newresearch.medilam.ac.ir/article-1-557-en.docx}, journal = {Technology and Research Information System}, issn = {}, eissn = {}, year = {2019} } @article{ author = {Asadolahi, Khairollah and jamshidimoghadam, farideh}, title = {Evaluating the risk factors of congenital hypothyroidism in the newborns in Mahshhar during 2005-2011 based on prevention model}, abstract ={}, Keywords = {}, volume = {2}, Number = {2}, pages = {0-0}, publisher = {}, url = {http://newresearch.medilam.ac.ir/article-1-549-en.html}, eprint = {http://newresearch.medilam.ac.ir/article-1-549-en.docx}, journal = {Technology and Research Information System}, issn = {}, eissn = {}, year = {2019} } @article{ author = {Deldar, Maryam and Sayehmiri, Kourosh}, title = {The effect of gluten- and casein- free diet on children with autism spectrum disorders (A systematic review and metanalysis)}, abstract ={<meta http-equiv=Content-Type content="text/html; charset=utf-8"><meta name=ProgId content=Word.Document><meta name=Generator content="Microsoft Word 15"><meta name=Originator content="Microsoft Word 15">                           وزارت بهداشت درمان و آموزش پزشکی دانشگاه علوم پزشکی و خدمات بهداشتی درمانی ایلام معاونت تحقیقات وفناوری   عنوان طرح:                          تأثیر رژیم غذایی فاقد گلوتن و کازئین در کودکان با اختلالات طیف اوتیسم                                                          مرور سیستماتیک و متاآنالیز     مجری طرح: مریم دلدار   استاد راهنما: دکتر کورش سایه میری   سال1398     سپاسگزاری و قدردانی سپاس و ستایش مر خدای را جل و جلاله که آثار قدرت او بر چهره روز روشن، تابان است و انوار حکمت او در دل شب تار، درفشان. آفریدگاری که خویشتن را به ما شناساند و درهای علم را بر ما گشود و عمری و فرصتی عطا فرمود تا بدان، بنده ضعیف خویش را در طریق علم و معرفت بیازماید. از استاد با کمالات و شایسته؛ جناب آقای دکتر کوروش سایه میری که در کمال سعه صدر، با حسن خلق و فروتنی، از هیچ کمکی در این عرصه بر من دریغ ننمودند و زحمت راهنمایی این طرح را بر عهده گرفتند و همچنین جناب آقای دکتر پرویز کریمی که مشاور من در این طرح بودند کمال تشکر و قدردانی را دارم.  تقدیم به : پدر و مادر عزیزم، به پاس تعبیر عظیم و انسانی شان از کلمه ایثار و از خودگذشتگی و به پاس عاطفه سرشار و گرمای امیدبخش وجودشان که در این سردترین روزگاران بهترین پشتیبان من است. ماحصل کارم را تقدیم می کنم به  فرشتگانی زیبا، معصوم و دوست داشتنی که گویی عالمشان با ما متفاوت است، تقدیم به کودکان اوتیسم. چکیده سابقه و هدف: اوتیسم اختلال رشد عصبی است که در مردان بیشتر از زنان رایج است و شیوع آن به طرز چشمگیری در سال های اخیر افزایش یافته است. اتیولوژی و درمان اوتیسم هنوز مشخص نیست؛ با افزایش رشد موارد اوتیسم در ایالات متحده و دیگر نقاط، خیلی از خانواده ها به فکر درمان افتادند. حدس زده می شود که رژیم ها ممکن است تأثیر روی سلامت روحی و تندرستی در انواعی از علایم رفتاری اوتیسم داشته باشد که کیفیت زندگی در این طیف را بهبود بخشد. هدف ازاین مطالعه بررسی تاثیر رژیم فاقد گلوتن و کازئین در اختلالات طیف اوتیسم است. روش کار: کلیه ی پایگاه های اطلاع رسانی داخلی و همچنین پایگاه های google scolor, pubmed, Cochrane, science direct,scopus با استفاده از کلیدواژه هایAutism, Gluten free, Casein free بدون محدودیت زمانی بررسی شدند. در ابتدا  224مقاله یافت شد که در عنوان و چکیده حاوی کلمات کلیدی بودند. با مرور عناوین 13مقاله ی کارآزمایی بالینی مرتبط وارد مرحله ارزیابی متن کامل مقاله شدند و در نهایت 9 مقاله مشمول معیارهای ورود تحلیل نهایی شدند. نتایج مطالعات با استفاده از مدل اثرات ثابت متا آنالیز با هم ترکیب شدند و همچنین برای بررسی ناهمگنی در میان مقالات انتخاب شده از آماره Q و شاخص I2 استفاده شد و برای تحلیل داده ها از نرم افزار Stata Ver. 14 استفاده شد. یافته ها: با ادغام نتایج این 9 مطالعه با تعداد 235 شرکت کننده ی اوتیسمی  و با استفاده از روش اثرات ثابت متا آنالیز در گروه های مداخله نشان داده شد که رژیم فاقد گلوتن و کازئین در کودکان اوتیسمی تاثیر معنی داری داشته است بطوری که  در شاخصbehavior دارای اندازه اثر(0.001=P)0.27-SMD=  با فاصله اطمینان (0.116-  0.424-) و در برچسب language دارای اندازه اثر(0.012=P) 0.287-SMD=  با فاصله اطمینان (0.063-  0.511-) و در برچسبsociability دارای اندازه اثر(0.001=P)0.51-SMD=  با فاصله اطمینان (0.22-    0.801-) می باشد. همچنین متا آنالیز بین گروه های مداخله و کنترل نشان داد که این رژیم دارای اندازه اثر(0.001=P) 0.27SMD= با فاصله اطمینان (0.429    0.112) در برچسب behavior می باشد. نتیجه گیری: با توجه به اینکه رژیم فاقد گلوتن و کازئین در بهبود رفتارهای خاص، زبان و اجتماعی بودن کودکان اوتیسمی مؤثر است می توان این رژیم را برای بهبود علائم رفتاری کودکان اوتیسمی به کار برد. کلمات کلیدی: فاقد گلوتن، فاقد کازئین، اوتیسم، اوتیستیک فهرست مطالب عنوان                                                                                                                   صفحه چکیده……………………………………………………………………………………….4 فصل اول: کلیات پژوهش...........................................................................................................................................10 1-1  بیان مسئله..........................................................................................................................................................11 1-2  اهداف و کلیات...................................................................................................................................................12 1-2-1 اهداف کلی.....................................................................................................................................................12 1-2-2 اهداف اختصاصی..........................................................................................................................................12 1-2-3  اهداف کاربردی..........................................................................................................................................12 1-2-4 سوالات پژوهش..........................................................................................................................................12 فصل دوم: چارچوب نظری و بررسی متون..........................................................................................................13 2-1 تعاریف...............................................................................................................................................................14 2-2 درمان های رایج..............................................................................................................................................14 2-3 مروری بر مطالعات انجام شده.....................................................................................................................16 فصل سوم: روش پژوهش........................................................................................................................................18 3-1 انواع مطالعه......................................................................................................................................................19 3-2 روش جستجو..................................................................................................................................................19 3-3 تحلیل آماری...................................................................................................................................................19 فصل چهارم: یافته های پژوهش...........................................................................................................................22 4-1 نتایج................................................................................................................................................................23 فصل پنجم: بحث و منابع....................................................................................................................................47 5-1 بحث...............................................................................................................................................................48 5-2 محدودیت ها................................................................................................................................................48 5-3  نتیجه............................................................................................................................................................49 منابع و مآخذ..........................................................................................................................................................50                               فهرست جداول عنوان...........................................................................................................................................................................صفحه جدول شماره 1: مشخصات مقالات مورد بررسی و نمرات گروه آزمایش و کنترل قبل و بعد از مداخله.....................................25 جدول شماره 2: اندازه اثر و فاصله اطمینان و شاخص ناهمگنیI2 در برچسب ها و گروه های مختلف.....................................29                                     فهرست نمودار عنوان.............................................................................................................................................................................. صفحه نمودار1............................................................................................................................................................................21 نمودار2............................................................................................................................................................................30 نمودار3............................................................................................................................................................................31 نمودار4.............................................................................................................................................................................32 نمودار5.............................................................................................................................................................................33 نمودار6..............................................................................................................................................................................34 نم.دار7................................................................................................................................................................................35 نمودار8...............................................................................................................................................................................36 نمودار9................................................................................................................................................................................37 نمودار10.............................................................................................................................................................................38 نمودار11.............................................................................................................................................................................39 نمودار12............................................................................................................................................................................40 نمودار13............................................................................................................................................................................41 نمودار14............................................................................................................................................................................42 نمودار15............................................................................................................................................................................43 نمودار16............................................................................................................................................................................43 نمودار17............................................................................................................................................................................44 نمودار18..........................................................................................................................................................................44 نمودار19..........................................................................................................................................................................45 نمودار20..........................................................................................................................................................................45 نمودار21...........................................................................................................................................................................46 نمودار22...........................................................................................................................................................................46                 فصل اول کلیات و اهداف پژوهش                       1-1 بیان مسئله اختلال طیف اوتیسم یک سندرم پیشرفته عصبی است که قبل از سه سالگی شروع می شود و با نقص فراگیر در تعامل اجتماعی، نقص در ارتباطات و الگوهای کلیشه ای علایق و فعالیت ها مشخص می شود. هیچ علت شناخته شده ای برای ASD وجود ندارد (Mulloy et al., 2010). توضیح وقوع  ASD، می تواند به پیچیدگی فنوتیپ های رفتاری و نیز دخالت های مختلف عوامل ژنتیکی و محیطی نسبت داده شود(El-Rashidy et al., 2017). اوتیسم اختلال رشد عصبی است که در مردان بیشتر از زنان رایج است و شیوع آن به طرز چشمگیری در سال های اخیر افزایش یافته است(Seung et al., 2007). سازمان بهداشت جهانی تخمین می زند که از هر 160 کودک یک کودک دارای اختلال اوتیسم وجود دارد(Piwowarczyk et al., 2018). اتیولوژی و درمان اوتیسم هنوز مشخص نیست (Seung et al., 2007)، با افزایش رشد موارد اوتیسم در ایالات متحده و دیگر نقاط خیلی از خانواده ها به فکر درمان افتادند (Johnson et al., 2011b). سازمان بهداشت جهانی (WHO) معتقد است که "بدون سلامت، سلامت روانی وجود ندارد (Kałużna-Czaplińska and Jóźwik-Pruska, 2016). بسیاری از مطالعات نشان داده اند که کودکان و بزرگسالان مبتلا به ASD اغلب دارای کمبود مواد غذایی، عدم تعادل متابولیکی و مشکلات گوارشی هستند. مطالعات متعدد تغذیه و رژیم غذایی را در درمان این شرایط مفید دانسته اند(Adams et al., 2018). در درمان اختلالات اوتیسم هم از طرف والدین و هم از طرف پزشکان علاقه ی رو به افزایشی  به سمت مداخله در رژیم غذایی است(Pedersen et al., 2014).  در سال 1983 پیشنهاد شد که محصولات حاوی گلوتن و کازئین می توانند علائم شبیه به اوتیسم را با تغییر عملکرد مغز ایجاد کنند(Ciéslińska et al., 2017). پیشنهاد شده است که پپتیدهای گلوتن و کازئین ممکن است در ریشه و روانشناسی اوتیسم نقش داشته باشند(Millward et al., 2019). پروتئین غذایی گلوتن (از گندم) و کازئین (از محصولات لبنی) شبیه هستند(Lange et al., 2015). حذف گلوتن شامل حذف همه مواد غذایی حاوی گندم، جو و جو چاودار است(Marí-Bauset et al., 2016). علاقه ی روبه افزایشی در استفاده از رژیم های فاقد گلوتن و کازئین برای بچه های با اختلالات طیف اوتیسم وجود دارد(Whiteley et al., 2010a).   مطالعه حاضر به منظور تعیین اثر رژیم غذایی فاقد گلوتن و کازئین در اختلالات طیف اوتیسم انجام شده است . از آنجا که تا کنون هیچ مطالعه ی متا آنالیز درباره ی تأثیر رژیم فاقد گلوتن و کازئین روی بچه های اوتیسم انجام نشده است در این مطالعه به بررسی این موضوع به روش سیستماتیک و متاآنالیز خواهیم پرداخت. 1-2 اهداف پژوهش 1-2-1 اهداف کلی تأثیر رژیم غذایی فاقد گلوتن و کازئین در بهبود اختلالات طیف اوتیسم 1-2-2 اهداف اختصاصی 1-    تأثیر رژیم غذایی فاقد گلوتن و کازئین در بهبود ارتباطات کلامی کودکان اوتیسم 2-    تأثیر رژیم غذایی فاقد گلوتن و کازئین در بهبود ارتباطات حسی و حرکتی کودکان اوتیسم 3-    تأثیر رژیم غذایی فاقد گلوتن و کازئین در بهبود مشکلات خواب کودکان اوتیسم 4-    تأثیر رژیم غذایی فاقد گلوتن و کازئین در بهبود روابط اجتماعی کودکان اوتیسم 5-    تأثبر رژیم غذایی فاقد گلوتن و کازئین در بهبود رفتارهای کودکان اوتیسم   1-2-3 اهداف کاربردی 1.     کمک به تصمیم گیری بهتر والدین کودکان اوتیسمی در انتخاب رژیم غذایی مناسب کودکشان 2.     کمک به پزشکان در شناسایی بیشتر حساسیت های کودکان اوتیسمی به مواد غذایی خاص 3.     یاری رساندن به سیاست گذاری بهتر حوزه بهداشت درباره اطلاع رسانی درست به خانواده های دارای کودکان اوتیسم 1-2-4 سوالات پژوهش 1.     آیا رژیم غذایی فاقد گلوتن و کازئین ارتباطات کلامی کودکان اوتیسم را بهبود می بخشد؟ 2.     آیا رژیم غذایی فاقد گلوتن و کازئین ارتباطات حسی و حرکتی کودکان اوتیسم را بهیود می بخشد؟ 3.     آیا رژیم غذایی فاقد گلوتن و کازئین مشکلات خواب کودکان اوتیسم را بهبود می بخشد؟ 4.     آیا رژیم غذایی فاقد گلوتن و کازئین روابط اجتماعی کودکان اوتیسم را بهبود می بخشد؟ 5.     آیا رژیم غذایی فاقد گلوتن و کازئین رفتارهای کودکان اوتیسم را بهبود می بخشد؟             فصل دوم چارچوب نظری و بررسی متون                       2-1 تعاریف اختلالات طیف اوتیسم را می توان از جمله اختلالات شایع دوران کودکی نام برد. شیوع این اختلال روز به روز در حال افزایش است. از مشخصات کودکان دارای اختلالات اوتیسم می توان به اختلال در ارتباط و تعاملات اجتماعی و رفتارهای محدود وتکراری اشاره کرد (Mohammadi et al., 2018). آن ها تمایل به استفاده از زبان تکراری برای درک یک سری از کلمات دارند(Reichelt and Knivsberg, 2003). اوتیسم ناتوانی است که عمیقا بر ارتباط برقرار کردن کودکان و ارتباط با مردم اطراف آن ها تأثیر می گذارد. کودکان مبتلا به اختلال طیف اوتیستیک (ASD) با اختلال در تعامل اجتماعی، مهارت های ارتباطی غلط یا ضعیف و نقص توسعه تخیل مشخص می شوند. این اختلالات ممکن است از دوران کودکی تا بزرگسالی ادامه یابد و بنابراین تاثیر منفی بر یادگیری دارد. شیوع روبه رشد این اختلالات توجه زیادی را به خود جلب کرده است، این اختلالات پیچیده و چند وجهی هستند. اگر چه توجه به اوتیسم به عنوان یک اختلال به نظر می رسد که جدید باشد اما حداقل از قرن 18 ام وجود داشته است. دکتر لئو کانر توصیف اولیه ای از اوتیسم در سال 1943  چاپ کرد وقتی که گروه کوچکی از بچه هایی را مشاهده کرد که خیلی از دیگر افراد کناره گیری می کردند و نسبت به بقیه بی تفاوت بودند. بچه های این طیف اساسا مشکلات یکسان ولی با درجه های متفاوت دارند. پنج اختلال در این طیف وجود دارد که هر کدام معیارهای مختلفی برای تشخیص دارند(Washnieski, 2009). از آنجا که اوتیسم هیچ علت یا درمانی ندارد، نیاز فوری به علم بیشتر در این زمینه وجود دارد(Elder et al., 2006). 2-2 درمان های رایج رایج ترین مداخله های دارویی توصیه شده، رفتار درمانی ها، آموزش والدین، درمان های شایسته، مدیریت دارویی، حمایت اجتماعی و درمان های دیگر، شامل مکمل های غذایی، رژیم های حذف ( مانندرژیم فاقد گلوتن و فاقد کازئین)، آموزش یکپارچه مربوط به شنوایی و ارتباط آسان است(Washnieski, 2009). مطالعات متعددی رفتارهای ناسازگار دراختلالات طیف اوتیسم((ASD را با اختلال عملکرد دستگاه گوارش و التهاب روده مربوط می دانند(Pusponegoro et al., 2015)، اغلب علائم گوارشی مانند اسهال یا یبوست گزارش شده است(Hyman et al., 2016b). آنها پیشنهاد می کنند که جذب غیرطبیعی گلوتن و کازئین در روده باعث تشدید شدن رفتار ناسازگارانه می شود؛ با این حال تعدادی از مطالعات هیچ ارتباطی بین علائم گوارشی و اختلالات ASD گزارش نکردند(Pusponegoro et al., 2015). گلوتن پروتئین موجود در گندم و کازئین پروتئین موجود در شیر و ماست در ایجاد بیماری اوتیسم بیش از دیگران مورد اتهام هستند. رژیم های ریزش  از رایج ترین روش های جایگزین است که در کودکان اوتیسم استفاده می شود و پروتئین های گلوتن و کازئین را از بین می برد. گلوتن یک پروتئین است که در مواد غذایی حاوی گندم، جو، چاودار و ... یافت می شود و معمولا به عنوان یک افزودنی در غذاهای فرآوری شده و اقلام روزانه استفاده می شود . کازئین پروتئینی که در محصولات شیر یافت می شود. رژیم های حذف همه ی این منابع را از مصرف روزانه ی کودک حذف می کنند  .(Knivsberg et al., 2002) علایم و نشانه های جسمی ، حسی، رفتاری کودکان اوتیسم متنوع است.  ATEC یک پرسشنامه است که توسط موسسه تحقیقات اوتیسم برای ارزیابی اثربخشی درمان در افراد مبتلا به اوتیسم توسعه یافته است که شامل چهار زیر مقیاس است,(El-Rashidy et al., 2017) ما هم در این کار برای راحتی از این زیر مقیاس ها استفاده می کنیم و علایم و نشانه های بیماران را براساس این چهارمقیاس برچسب گذاری می کنیم. I-Speech/Language/Communication II- Sociability III- Sensory/ Cognitive Awareness IV- Health/Physical/Behavior طبق گزارشات مقالات مختلفی که در این متاآنالیز استفاده شده است سعی کردیم هر علامت گزارش شده را در برچسب مناسب خودش قرار دهیم. بنابراین برچسب هایی که ما در این متاآنالیز بررسی میکنیم عبارتند از: 1-زبان((language 2-روابط اجتماعی(sociability) 3-حسی/ ادراکی/ حرکتی(sensory/motor) 4-رفتار(behavior) برچسب language شامل: communication, verbal, speech, receptive language, expressive language برچسب sociability شامل: social, social relationship, social isolation    برچسب sensory/motor شامل:  sensory responces, cognitive, motor problem,Fine motor و  برچسب behavior شامل :Emotional , Anxious, Somatic, Withdrawn , Sleep , Attention , Aggression Internalizing , Externalizing , Total , Affective , Anxiety , PDD , ADHD, Attend, initiate, Affectual reactions, minutes of sleep, waiking, Expectant waiting, Intelligible words,Autistic rait  می باشد.   2-3 مروری بر مطالعات انجام شده susan L. Hyman   و همکاران در سال 2016 به بررسی امنیت و تاثیر رژیم فاقد گلوتن وکازئین روی 14 کودک پرداختند نتایج از نظر آماری روی اندازه اثر نمودارهای فیزیولوژی ، مشکلات رفتاری و علائم اوتیسم معنادار نبود. Cynthia R. Johnson و همکاران در سال 2010  مطالعه ی آزمایشی سه ماهه ای را انجام دادند و برخی از دستاوردها را در متغیرها نشان دادند، در متغیرهایی مانند زبان، رفتار و ویژگی های اصلی تفاوت آماری معناداری بین گروه ها وجود نداشت. Gennifer  Harrison  و همکاران در سال 2006 در مطالعه ای اثر رژیم فاقد گلوتن وکازئین را در رفتار کودکان اوتیسم با استفاده از یک اندازه گیری دوسو کور تکرارشده به صورت تصادفی انجام دادند. داده ها در طی 12 هفته جمع آوری شد، داده ها یافته های آماری معناداری نشان نداد هرچند که بعضی والدین بهبود را در فرزندانشان گزارش کردند. HyeKyeung Seung  و همکارانش مطالعه ای را در سال 2007 برای تأثیر این رژیم غذایی بر ارتباط کلامی و غیر کلامی کودکان اوتیسم بررسی کردند و داده ها بصورت تصادفی و دوسوکور جمع آوری شد که پس از 6 هفته تفاوت معناداری در ارتباط کلامی و غیر کلامی نشان ندادند. Paul whitely و همکارانش در سال 2010 مطالعه ی مورد شاهدی از رژیم فاقد گلوتن و کازئین روی 26 کودک اوتیسمی همراه با رژیم و 29 شاهد بدون رژیم انجام دادند که بهبودی های معناداری در سطح اوتیستیک و رفتارهای مربوطه بعد از 8 تا 12 ماه روی این رژیم مشاهده شد. Hardiono D.Pusponegoro و همکاران در سال 2015 روی 74 کودک اوتیسمی این رژیم را به صورت دوسوکور به مدت یک هفته انجام دادند که تفاوت معناداری در علایم معدی و روده ای مشاهده نشد. در مطالعه ای دیگر که در سال 2017 روی 45 کودک دارای اختلالات اوتیسمی انجام شد ، اثر این رژیم و رژیم کتوژنیک بصورت جداگانه بررسی شد. در این مطالعه کودکان بصورت تصادفی به سه دسته 15 تایی شامل گروه کنترل، گروه رژیم فاقد گلوتن و کازئین و گروه رژیم کتوژنیک تقسیم شدند که گروه رژیم فاقد گلوتن و کازئین در زبان و رفتار بهبود های معناداری را بعد از دوره ی 6 ماهه نشان دادند. K.L. REICHELT و A.-M. KNIVSBERG درمطالعه ای در سال 2002 اثر این رژیم را روی 20 کودک اوتیسمی که به دو گروه مداخله و کنترل تقسیم شده بودند در یک دوره یکساله بررسی کردند؛ نتایج قبل و بعد نشان داد که پیشرفت بچه هایی که در گروه رژیم بودند به طور معناداری بهتر از گروه کنترل بود. این دو نویسنده قبلا هم در سال 1995 اثر این رژیم را روی 14 کودک اوتیسمی در یک دوره یکساله و 4 ساله بررسی کرده بودند که در آنجا هم پیشرفت های معناداری در گروه مداخله دیده شد.                             فصل سوم روش پژوهش       3-1 نوع مطالعه این مطالعه از نوع مروری و شامل کلیه ی مطالعات کارآزمایی بالینی است که تأثیر رژیم فاقد گلوتن و کازئین را در اختلالات طیف اوتیسم، صرف نظر از زمان مطالعه و زبان مقالات مورد بررسی قرار می دهد. پیامد مورد مطالعه بررسی میزان تأثیر رژیم فاقد گلوتن و کازئین بر اختلالات طیف اوتیسم براساس متغیرهای ارتباطات کلامی، ارتباطات حسی و ادراکی، روابط اجتماعی و رفتارهای کودکان اوتیسم است. 3-2 روش جستجو روش کار بصورت مرور سیستماتیک و فراتحلیل است که با استفاده از کلیدواژه های   Gluten free, Casein free, Autism کلیه ی پایگاه های داخلی و همچنین پایگاه های google scolor, pubmed , Cochrane, science direct بدون محدودیت زمانی بررسی شدند و مقالاتی که در عنوان وچکیده شامل کلیدواژه های فوق بودند انتخاب شدند، در مرحله ی بعد مقالاتی که کارآزمایی بالینی بودند وارد مرحله ی بررسی بیشتر شدند. در ابتدا 176 مقاله یافت شد که در عنوان و چکیده حاوی کلمات کلیدی بودند. پس از بررسی، 85 مقاله تکراری و دارای هم پوشانی حذف شدند و در مرحله بعد پس از مرور عناوین و چکیده  13 مقاله کارآزمایی بالینی مرتبط وارد مرحله ارزیابی متن کامل مقاله شدند و در نهایت 9 مقاله مشمول معیارهای ورود تحلیل نهایی شدند.  معیار ورود کلیه ی کارآزمایی بالینی های شامل رژیم فاقد گلوتن و کازئین بدون محدودیت زمانی بودند و معیارهای خروج شامل غیر مرتبط بودن مقاله با موضوع، در دسترس نبودن مقاله، مقالات شامل رژیم فاقد گلوتن به تنهایی، مقالات شامل رژیم فاقد کازئین به تنهایی بودند. در نهایت کلیه ی تحلیل ها توسط نرم افزار spssو , stata انجام شد و برای بررسی ناهمگنی در میان مقالات انتخاب شده از متارگرسیون استفاده شد. 4-3 تحلیل آماری در هر مطالعه میانگین و انحراف معیار قبل و بعد در هر دو گروه آزمایش و کنترل، نام نویسنده، سال انجام تحقیق، تعداد نمونه و محل انجام مطالعه و نتیجه ی آزمون وارد نرم افزار spss شد و یکسری آنالیزهای مقدماتی روی داده ها انجام شد و چون متاآنالیز با این نرم افزار صورت نمی گیرد داده ها وارد نرم افزار stata شدند و متا آنالیز با این نرم افزار انجام شد. در هر مطالعه میانگین نمره در گروه شاهد و مورد اندازه گیری شد و اندازه اثر کلی استاندارد شده توسط فرمول زیر محاسبه شد.                                                                               SMD= که Ese اندازه اثر گروه آزمایش و Esc اندازه اثر گروه کنترل است و واریانس مشترک SD توسط فرمول زیر محاسبه می شود. SD2=                                      برای بررسی همگنی میان مقالات از آماره Q و شاخص I2 استفاده شد و با توجه به اینکه ناهماهنگی میان مقالات در متا آنالیزهای مختلف بین گروه های آزمایش و کنترل و یا گروه آزمایش قبل و بعد از مداخله و یا گروه کنترل قبل و بعد از مداخله در برچسب های مختلف به جز در سه مورد، معنادار نبود از روش مدل اثرات ثابت  fixed effect model برای آن ها استفاده شد. برای سه موردی که ناهمگنی معنادار بود از مدل اثرات تصادفی random effect model استفاده شد. برای بررسی اثر هر مطالعه، با حذف مطالعه از هر مدل اثر کلی محاسبه شد. برای بررسی ارتباط بین سال انتشار و تعداد نمونه با اندازه اثر از مدل متا رگرسیون استفاده شد. برای بررسی اثر سوگیری انتشار از نمودار publication bias plot استفاده شد.                 224 of records identified through database searching 85 of records after duplicates removed 122 of records screened 47 of records excluded 75 of full-text articles assessed for eligibility 13 of studies included in qualitative synthesis 62 of full-text articles excluded, with reasons 9 of studies included in quantitative synthesis (meta-analysis) 13 مقاله کارآزمایی بالینی وارد مرحله بررسی بیشترشدند                                                                                                                                   نمودار 1. فلوچارت مراحل ورود مطالعات به مرور سیستماتیک و متا آنالیز           فصل چهارم یافته های پژوهش                     4-1 نتایج ابتدا 224 مقاله از کلیه ی پایگاه های داخلی و خارجی انتخاب شدند که در عنوان یا چکیده حاوی کلمات کلیدی بودند. پس از حذف هم پوشانی ها و مقالات کنفرانس و کتاب ها، 122 مقاله باقی ماند که با بررسی عناوین و چکیده ها 13 مقاله ی کارآزمایی بالینی انتخاب شد که 9تا از این مقالات کارآزمایی بالینی مورد بررسی،  معیار ورود به مطالعه را داشتند. در این 9 مقاله با تعداد 235 نفرشرکت کننده ی اوتیسمی، 128 نفر در گروه آزمایش و 105 نفر در گروه کنترل بودند. تعداد نمونه در مطالعات مختلف بین 13 تا 55 نفر متغیر بود که جزئیات روش جستجو در شکل 1 نشان داده شده است.  شرکت کننده ها کودکان اوتیسمی بودند. در 4 مقاله تفاوت معناداری بین قبل و بعد از مداخله در رژیم فاقد گلوتن و کازئین وجود نداشت و در 5 مقاله دیگر در اکثر شاخص ها تفاوت معناداری بین قبل و بعد از مداخله وجود داشت، همچنین در این 5 مقاله بین گروه مداخله و کنترل هم در اکثر شاخص ها تفاوت معناداری وجود داشت. 7 مقاله زیر مقیاس هایی از برچسب رفتار گزارش کرده بودند ، 7 مقاله زیر مقیاس هایی از برچسب زبان را گزارش کرده بودند. در 5 مقاله زیر مقیاس هایی از برچسب حسی حرکتی و در 4 مقاله زیر مقیاس های اجتماعی بودن گزارش شده بود.  از این 9 مطالعه، دوتا متقاطع، یکی کوهورت و بقیه مورد-شاهدی بودند که بعضی دوسوکور و بعضی یک سو کور بودند. مقاله (Elder et al., 2006) چون بصورت متقاطع انجام شده بود اطلاعات گروه کنترل را نمی شد وارد کرد و فقط شامل اطلاعات گروه مورد هست. مقاله(Hyman et al., 2016b) هم بدلیل نوع خاص طراحی توانستیم فقط از اطلاعات گروه مداخله استفاده کنیم و فاقد گروه کنترل شد. در مقاله (Whiteley et al., 2010a) هم انحراف معیار گزارش نشده بود که میانگین انحراف معیار مقالات دیگر در برچسب های مورد نظر وارد متا آنالیز شد. behavior 7 مطالعه زیر مقیاس هایی از برچسب behavior را بررسی کرده بودند اکثر مطالعات رابطه مثبت را نشان داده بودند. با ادغام نتایج این 7 مطالعه برای متا آنالیز بین گروه های مداخله و کنترل فقط 5 مطالعه معیار ورود به متاآنالیز را داشتند که با استفاده از روش اثرات ثابت(851(I2=0,pvalue=0. نشان داده شد که اثر رژیم فاقد گلوتن و کازئین در کودکان با اختلالات طیف اوتیسم در برچسب  behavior دارای اندازه اثر 0.27SMD= با فاصله اطمینان (0.429     0.112) می باشد. در متا آنالیز بین گروه های مداخله در برچسب  behavior، با حذف سه زیرمقیاس پرت 5 مطالعه وارد متا آنالیز شدند که با استفاده از روش اثرات ثابت (I2=0, pvalue=1) رژیم فاقد گلوتن و کازئین در این برچسب دارای اندازه اثر0.27-SMD= با فاصله اطمینان(0.116-     0.424-) بود. Language  7 مطالعه زیر مقیاس هایی از برچسب language را بررسی کرده بودند اکثر مطالعات رابطه مثبت را نشان داده بودند. با ادغام نتایج این 7 مطالعه برای متا آنالیز بین گروه های مداخله هر 7  مطالعه معیار ورود به متاآنالیز را داشتند که با استفاده از روش اثرات ثابت (58(I2=0,pvalue=0.9 نشان داده شد که اثر رژیم فاقد گلوتن و کازئین در کودکان با اختلالات طیف اوتیسم در برچسب  language دارای اندازه اثر0.287-SMD= با فاصله اطمینان (0.063-     0.511-) می باشد. sociability 4 مطالعه زیر مقیاس هایی از برچسب sociability را بررسی کرده بودند که اکثر مطالعات رابطه مثبت را نشان داده بودند. با ادغام نتایج این 4 مطالعه برای متا آنالیز بین گروه های مداخله هر 4 مطالعه معیار ورود به متاآنالیز را داشتند. با حذف یک مورد زیرمقیاس پرت با استفاده از روش اثرات ثابت متا آنالیز (I2=0,pvalue=0.604) نشان داده شد که این رژیم در برچسب  sociabilityدارای اندازه اثر-0.51     SMD= با فاصله اطمینان (-0.801    -0.22) می باشد.  متا آنالیز های مختلف  بین گروه های مداخله و کنترل در جدول شماره 2 نشان داده شده است که به جز این چهار مورد ذکر شده بقیه معنادار نشدند. ناهمگنی میان مطالعات در متا آنالیز های مختلف مشاهده نشد. در متا آنالیز های مختلف و در برچسب های متفاوت با استفاده از متارگرسیون هیچ رابطه ی معناداری بین اندازه اثر و تعداد نمونه و همچنین اندازه اثر و سال انتشار پیدا نشد( نمودارهای6و7و8و9).     نام نویسنده سال   تأثیر رژیم فاقد گلوتن و کازئین بر تعداد نمونه کشور گروه آزمایش گروه کنترل قبل از مداخله بعد از مداخله قبل از مداخله بعد از مداخله میانگین انحراف معیار میانگین انحراف معیار میانگین انحراف معیار میانگین انحراف معیار 1 HyeKyeng Seung 2007 Verbal responses 13 USA (florida) 16 27 11 12 16 27 15 18 1 HyeKyeng Seung 2007 verbal imitation 13 USA (florida) 3.85 6.9 1.85 2.23 3.85 6.9 3.54 7.84 1 HyeKyeng Seung 2007 Lexical Productions 13 USA (florida) 35 37 32 33 35 37 37 34 1 HyeKyeng Seung 2007 Utterance Productions 13 USA (florida) 42 54 36 35 42 54 45 47 2 A.M.Knivsberg 2002 Autistic traits 20 Norway 12.5 2.2 5.6 2.4 11.5 3.9 11.2 5 2 A.M.Knivsberg 2002 Nonverbal cognitive level 18 Norway 81 35.9 86.7 38.5 84.6 36.6 74.3 31.4 2 A.M.Knivsberg 2002 Linguistic age 18 Norway 55.4 32.3 66.6 35.1 47.8 23.9 55.7 28.3 2 A.M.Knivsberg 2002 Motor problem 20 Norway 29.3 13.1 26.3 11.5 24.7 14.6 27.8 12.2 3 Omnia El-Rashidy 2017 Speech 30 agypt 21.20 8.14 15.47 3.78 22.93 11.54 23 11.33 3 Omnia El-Rashidy 2017 Sociability 30 agypt 17.53 4.41 16.73 4.17 17.87 2.8 17.93 2.43 3 Omnia El-Rashidy 2017 Cognition 30   agypt 18.33 7 15.07 5.41 19.33 6.77 19.40 6.95 3 Omnia El-Rashidy 2017 Behavior 30   agypt 16.53 6.73 11.8 4.78 13.73 4.17 13.72 4.18 4 Cynthia R. Johnson 2010 Fine motor 22 USA (Pittsburgh) 28.3 12.8 28 12.1 27.9 10.8 30.1 10.3 4 Cynthia R. Johnson 2010 Receptive Language 22 USA (Pittsburgh) 26.1 13.6 26.9 11.6 23.5 13.6 25 13.5 4 Cynthia R. Johnson 2010 Expressive language 22 USA (Pittsburgh) 21 10.2 25 10.5 21.5 11.6 22.9 12.9 4 Cynthia R. Johnson 2010 Emotional 22 USA (Pittsburgh) 60.3 8.05 63.9 14.8 59.8 8.87 59.8 9.96 4 Cynthia R. Johnson 2010 Anxious/Depend. 22 USA (Pittsburgh) 59.1 9.23 57.4 7.75 56.7 8.8 56.8 8.17 4 Cynthia R. Johnson 2010 Somatic 22 USA (Pittsburgh) 57.4 6.19 53.3 4.5 58.5 8.35 56.7 5.65 4 Cynthia R. Johnson 2010 Withdrawn 22 USA (Pittsburgh) 71.1 9.76 72.6 10.9 73.6 10.1 69.5 10.4 4 Cynthia R. Johnson 2010 Sleep 22 USA (Pittsburgh) 57.6 9.94 53 3.51 55.8 5.33 53.6 4.65 4 Cynthia R. Johnson 2010 Attention 22 USA (Pittsburgh) 64.1 6.69 64.1 6.24 61 6.68 63.3 7.3 4 Cynthia R. Johnson 2010 Aggression 22 USA (Pittsburgh) 62 13.3 59.1 9.46 56 8.56 57.3 9.91 4 Cynthia R. Johnson 2010 Internalizing 22 USA (Pittsburgh) 64 5.73 62.9 4.36 62.7 9.38 60.7 9.49 4 Cynthia R. Johnson 2010 Externalizing 22 USA (Pittsburgh) 62.8 10.8 60.5 7.48 54.5 11.3 56.5 11.4 4 Cynthia R. Johnson 2010 Affective 22 USA (Pittsburgh) 64.6 7.67 60.6 10.8 62.2 8.31 59.1 6.98 4 Cynthia R. Johnson 2010 Anxiety 22 USA (Pittsburgh) 59.4 11.1 58.1 10.5 57.1 9.79 58.1 10.5 4 Cynthia R. Johnson 2010 PDD 22 USA (Pittsburgh) 75.4 5.76 75.6 5.55 73.3 7.92 71.6 7.3 4 Cynthia R. Johnson 2010 ADHD 22 USA (Pittsburgh) 60.4 8.62 58.4 6.3 58.7 7.77 60.4 7.47 4 Cynthia R. Johnson 2010 Verbal 22 USA (Pittsburgh) 19 6.37 15.5 8.93 16 9.79 14.9 9.77 4 Cynthia R. Johnson 2010 Attend 22 USA (Pittsburgh) 28.1 5.46 23.4 10.3 24.2 6.68 23.3 7.84 4 Cynthia R. Johnson 2010 Initiate 22 USA (Pittsburgh) 2.38 1.92 3.5 3.67 3.46 3.28 3.58 4.52 5 Hardiono D.Pusponegoro 2015 AWPC 50 Indonesia 56.96 11.72 39.38 2.89 57.08 11.46 39.63 3.05 6 Paul Whiteley 2010 GARS-social 55 Denmark 6.96 5.71 5.38 5.78 6.41 2.43 6 2.8 6 Paul Whiteley 2010 GARS-communication 55 Denmark 7.23 15.14 5.74 19.28 7.28 19.67 5.81 22.32 6 Paul Whiteley 2010 GARS-stereotyped 55 Denmark 6.81 10.75 5.35 11.4 6.76 7.32 5.37 7.92 6 Paul Whiteley 2010 VABS-communication 55 Denmark 66.46 15.14 67.38 19.28 62.45 19.67 64.07 22.32 6 Paul Whiteley 2010 VABS-social 55 Denmark 64.58 5.71 66.12 5.78 64.03 2.43 61.21 2.8 6 Paul Whiteley 2010 VABS-daily living 55 Denmark 59.88 10.75 63.35 11.4 55.55 7.32 53.96 7.92 6 Paul Whiteley 2010 ADHD-inattention 55 Denmark 11.96 10.75 9.77 11.4 11.21 7.32 11.11 7.92 6 Paul Whiteley 2010 ADHD-hyperactivity 55 Denmark 10.31 10.75 8.62 11.4 10.79 7.32 10 7.92 7 Jennifer Harrison Elder 2006 Child initiating 8 USA (florida) 7.5 6.1 10.8 8.4         7 Jennifer Harrison Elder 2006 Child responding 8 USA (florida) 14.3 6.5 11.9 4.5         7 Jennifer Harrison Elder 2006 Intelligible words 8 USA (florida) 24 43.5 30.9 36         7 Jennifer Harrison Elder 2006 Parent initiating 8 USA (florida) 71.6 34.9 64.3 30.4         7 Jennifer Harrison Elder 2006 Parent responding 8 USA (florida) 20.1 13.6 20.3 7.3         7 Jennifer Harrison Elder 2006 Expectant waiting 8 USA (florida) 1.9 2.7 2.3 2.2         8 A.M.Knivsberg 2003 Social interaction 14 Norway 53.7 15.2 65.8 15.2         8 A.M.Knivsberg 2003 Social isolation 14 Norway 8.5 3.3 2.4 3.3         8 A.M.Knivsberg 2003 Language 14 Norway 71 15.2 79.7 15.2         8 A.M.Knivsberg 2003 Sensory/Motor 14 Norway 72.9 12.3 80.1 12.3         8 A.M.Knivsberg 2003 Bizarre traits 14 Norway 5.3 2.2 0 2.2         9 Susan L. Hyman 2015 Language 14 USA (NewYork) 0.11- 0.3 0.01- 0.3         9 Susan L. Hyman 2015 Sensory responses 14 USA (NewYork) 0.27 0.21 0.27 0.19         9 Susan L. Hyman 2015 Sensory motor 14 USA (NewYork) 0.22 0.26 0.35 0.32         9 Susan L. Hyman 2015 Social relationships 14 USA (NewYork) 0.38- 0.17 0.25- 0.22         9 Susan L. Hyman 2015 Affectual reactions 14 USA (NewYork) 0.13 0.18 0.08 0.16         9 Susan L. Hyman 2015 Wakings 14 USA (NewYork) 0.27 0.55 0.13 0.5         9 Susan L. Hyman 2015 Minutes of sleep 14 USA (NewYork) 618 80.7 627 70.8             گروه و صفت مورد بررسی تعداد مقاله یا شاخص pvalue حد بالا حد پایین SMD pvalue I2 برچسب behavior در گروه آزمایش و کنترل بعد از رژیمGFCF 22 0.001 0.429 0.112 0.27 0.851 0 برچسب language در گروه آزمایش و کنترل بعد از رژیمGFCF 11 0.48 0.323 0.154- 0.085 0.999 . برچسب sensory/motor در گروه آزمایش و کنترل بعد از رژیمGFCF 4 0.808 0.471 0.367- 0.052 0.711 0 برچسب behavior در گروه آزمایش قبل و بعد از رژیمGFCF 29 0.001 0.116- 0.424- 0.27- 1 0 برچسب language گروه آزمایش قبل و بعد از رژیمGFCF 13 0.012 0.063- 0.511- 0.287- 0.958 0 برچسب sensory در گروه آزمایش قبل و بعد از رژیمGFCF 7 0.051 0.001 0.609- 0.304- 0.9 0 برچسب social در گروه آزمایش قبل و بعد از رژیمGFCF 5 0.001 0.22- 0.801- 0.51- 0.604 0 برچسب behavior در گروه کنترل قبل و بعد از رژیمGFCF 22 0.351 0.109 0.306- 0.099- 0.004 49.8% برچسب language در گروه کنترل قبل و بعد از رژیمGFCF 11 0.5 0.151 0.305- 0.077- 1 0 برچسب sensory/motor  در گروه کنترل قبل و بعد از رژیمGFCF 4 0.82 0.448 0.355- 0.047 0.821 0 برچسب behavior در گروه آزمایش و کنترل قبل از رژیمGFCF 22 0.52 0.106 0.21- 0.052- 0.641 0 برچسب language در گروه آزمایش و کنترل قبل از رژیمGFCF 11 0.644 0.184 0.297- 0.057- 0.71 0 برچسب sensory/motor در گروه آزمایش و کنترل قبل از رژیمGFCF 4 0.212 0.153 0.69- 0.268- 0.577 0 جدول شماره2. اندازه اثر و فاصله اطمینان و شاخص ناهمگنI2 در برچسب ها و گروه های مختلف   نمودار 2: اندازه اثر استاندارد شده در گروه آزمایش و کنترل بعد از رژیم فاقد گلوتن و کازئین در برچسب behavior: طول پاره خط فاصله اطمینان 95 درصدی را برای اندازه اثر استاندارد شده نشان می دهد و علامت لوزی اندازه اثر کلی و فاصله اطمینان 95 درصدی آن را نشان می دهد.                                                              نمودار 3: اندازه اثر استاندارد شده در گروه آزمایش قبل و بعد از رژیم فاقد گلوتن و کازئین در برچسب behavior: طول پاره خط فاصله اطمینان 95 درصدی را برای اندازه اثر استاندارد شده نشان می دهد و علامت لوزی اندازه اثر کلی و فاصله اطمینان 95 درصدی آن را نشان می دهد.                                                              نمودار 4: اندازه اثر استاندارد شده در گروه کنترل قبل و بعد از رژیم فاقد گلوتن و کازئین در برچسب behavior: طول پاره خط فاصله اطمینان 95 درصدی را برای اندازه اثر استاندارد شده نشان می دهد و علامت لوزی اندازه اثر کلی و فاصله اطمینان 95 درصدی آن را نشان می دهد.                                                               نمودار 5: اندازه اثر استاندارد شده در گروه آزمایش وکنترل قبل از رژیم فاقد گلوتن و کازئین در برچسب behavior: طول پاره خط فاصله اطمینان 95 درصدی را برای اندازه اثر استاندارد شده نشان می دهد و علامت لوزی اندازه اثر کلی و فاصله اطمینان 95 درصدی آن را نشان می دهد.                                                                  نمودار6: اندازه اثر استاندارد شده در گروه آزمایش وکنترل بعد از رژیم فاقد گلوتن و کازئین در برچسب language: طول پاره خط فاصله اطمینان 95 درصدی را برای اندازه اثر استاندارد شده نشان می دهد و علامت لوزی اندازه اثر کلی و فاصله اطمینان 95 درصدی آن را نشان می دهد.                                                                   نمودار7: اندازه اثر استاندارد شده در گروه آزمایش قبل و بعد از رژیم فاقد گلوتن و کازئین در برچسب language: طول پاره خط فاصله اطمینان 95 درصدی را برای اندازه اثر استاندارد شده نشان می دهد و علامت لوزی اندازه اثر کلی و فاصله اطمینان 95 درصدی آن را نشان می دهد.                                                                نمودار8: اندازه اثر استاندارد شده در گروه کنترل قبل و بعد از رژیم فاقد گلوتن و کازئین در برچسب language: طول پاره خط فاصله اطمینان 95 درصدی را برای اندازه اثر استاندارد شده نشان می دهد و علامت لوزی اندازه اثر کلی و فاصله اطمینان 95 درصدی آن را نشان می دهد.                                                                 نمودار9: اندازه اثر استاندارد شده در گروه آزمایش و کنترل قبل از رژیم فاقد گلوتن و کازئین در برچسب language: طول پاره خط فاصله اطمینان 95 درصدی را برای اندازه اثر استاندارد شده نشان می دهد و علامت لوزی اندازه اثر کلی و فاصله اطمینان 95 درصدی آن را نشان می دهد.                                                                 نمودار10: اندازه اثر استاندارد شده در گروه آزمایش و کنترل بعد از رژیم فاقد گلوتن و کازئین در برچسب sensory/motor: طول پاره خط فاصله اطمینان 95 درصدی را برای اندازه اثر استاندارد شده نشان می دهد و علامت لوزی اندازه اثر کلی و فاصله اطمینان 95 درصدی آن را نشان می دهد.                                                             نمودار11: اندازه اثر استاندارد شده در گروه آزمایش قبل و بعد از رژیم فاقد گلوتن و کازئین در برچسب sensory/motor: طول پاره خط فاصله اطمینان 95 درصدی را برای اندازه اثر استاندارد شده نشان می دهد و علامت لوزی اندازه اثر کلی و فاصله اطمینان 95 درصدی آن را نشان می دهد.                                                               نمودار12: اندازه اثر استاندارد شده در گروه کنترل قبل و بعد از رژیم فاقد گلوتن و کازئین در برچسب sensory/motor: طول پاره خط فاصله اطمینان 95 درصدی را برای اندازه اثر استاندارد شده نشان می دهد و علامت لوزی اندازه اثر کلی و فاصله اطمینان 95 درصدی آن را نشان می دهد.                                                                نمودار13: اندازه اثر استاندارد شده در گروه آزمایش و کنترل قبل از رژیم فاقد گلوتن و کازئین در برچسب sensory/motor: طول پاره خط فاصله اطمینان 95 درصدی را برای اندازه اثر استاندارد شده نشان می دهد و علامت لوزی اندازه اثر کلی و فاصله اطمینان 95 درصدی آن را نشان می دهد.                                                                نمودار14: اندازه اثر استاندارد شده در گروه آزمایش قبل و بعد از رژیم فاقد گلوتن و کازئین در برچسب sociability: طول پاره خط فاصله اطمینان 95 درصدی را برای اندازه اثر استاندارد شده نشان می دهد و علامت لوزی اندازه اثر کلی و فاصله اطمینان 95 درصدی آن را نشان می دهد.                                                            نمودار15: نمودار اندازه اثر و تعداد نمونه در برچسب رفتار بعد از مداخله در گروه آزمایش و کنترل معنادار نشد یعنی حجم نمونه ی کمتر یا بیشتر اندازه اثر را بالاتر یا پایین تر گزارش نمی کند.     نمودار16: نمودار اندازه اثر و سال در برچسب رفتار بعد از مداخله در گروه آزمایش و کنترل معنادار نشد یعنی نمی توان گفت مطالعاتی که در یک دوره زمانی خاص انجام شده اند، اندازه اثر را بالاتر یا پایین تر گزارش می کنند.                                                       نمودار17: نمودار اندازه اثر و تعداد نمونه در برچسب رفتار قبل و بعد از مداخله در گروه آزمایش معنادار نشد یعنی حجم نمونه ی کمتر یا بیشتر اندازه اثر را بالاتر یا پایین تر گزارش نمی کند.                                                                                                نمودار18: نمودار اندازه اثر و سال در برچسب رفتارقبل و بعد از مداخله در گروه آزمایش معنادار نشد یعنی نمی توان گفت مطالعاتی که در یک دوره زمانی خاص انجام شده اند، اندازه اثر را بالاتر یا پایین تر گزارش می کنند.                                                                                                  نمودار19: نمودار اندازه اثر و تعداد نمونه در برچسب  languageقبل و بعد از مداخله در گروه آزمایش معنادار نشد یعنی تعداد نمونه ی کمتر یا بیشتر اندازه اثر را بالاتر یا پایین تر گزارش نمی کنند.                                                                                                   نمودار20: نمودار اندازه اثر و سال در برچسب language قبل و بعد از مداخله در گروه آزمایش معنادار نشد یعنی نمی توان گفت مطالعاتی که در یک دوره زمانی خاص انجام شده اند، اندازه اثر را بالاتر یا پایین تر گزارش می کنند.                                                                                                                                                                                            نمودار 21: سوگرایی انتشار در برچسبbehavior قبل و بعد از مداخله در گروه آزمایش معنادار نشد. نمودار 22: سوگرایی انتشار در برچسبlanguage قبل و بعد از مداخله در گروه آزمایش معنادار نشد                 فصل پنجم بحث و منابع                       بحث مطالعات زیادی اثر رژیم فاقد گلوتن و کازئین را در کودکان با اختلالات اوتیسم بررسی کرده اند، اما شواهد کافی برای اثرپذیری این رژیم وجود ندارد. در مطالعه (Reichelt and Knivsberg, 2003) که شرکت کننده ها این رژیم را در یک دوره ی یکساله دریافت کردند بهبودی های معناداری در شاخص های رفتاری، زبان، روابط اجتماعی و توانایی حسی/حرکتی این کودکان مشاهده شد؛ همچنین مطالعه (El-Rashidy et al., 2017) بعد از یک دوره ی6 ماهه بهبودی های معناداری در شاخص های رفتار، زبان، ATEC و CARS نشان داد. بطور مشابه مطالعه ی (Knivsberg et al., 2002) هم که در یک دوره ی یکساله این مداخله ی رژیمی را روی کودکان اوتیسمی اعمال کرده بود نتایج معنادار مثبتی را در رفتارهای اوتیسمی، ادراک غیر لغوی و مشکلات حرکتی مشاهده کرد. اما در مطالعات دیگر که دوره ی درمان کوتاه تر بوده نتایج اکثرا معنادار نشده اند، مثلا مطالعه ی (Pusponegoro et al., 2015) در یک دوره هفت روزه و مطالعه (Johnson et al., 2011a) در یک دوره ی 3 ماهه نتایج معناداری نشان ندادند. بنابراین به علت دوره ی زمانی کوتاه بعضی مطالعات و همچنین عدم رعایت اصول تصادفی سازی کامل کارآزمایی های بالینی ارزیابی های بیشتری توصیه می گردد. مطالعه ی حاضر اولین مطالعه ی متا آنالیز با هدف بررسی اثر رژیم فاقد گلوتن و کازئین در اختلالات طیف اوتیسم است. در بررسی گروه های مداخله در مطالعات مختلف این رژیم در اختلالات طیف اوتیسم در برچسب  behavior و language وsociability دارای اندازه اثر معنادار در جهت مثبت شد. همچنین متا آنالیز بین گروه های مداخله و کنترل هم نشان داد که این رژیم دارای اندازه اثرمعناداری در برچسب behavior می باشد. محدودیت ها متاآنالیزی که ما در این کار انجام دادیم ترکیبی از داده ها در سراسر مطالعات  برای برآورد اثر رژیم فاقد گلوتن و کازئین در اختلالات طیف اوتیسم بود و اثر بیشتری نسبت به مطالعات تکی دارد. محدودیت اصلی این متاآنالیز، همانند هر مرور کلی، این است که شرکت کنندگان در مطالعه، رژیم فاقد گلوتن و کازئین و تعاریف نتیجه در مطالعات مختلف یکسان نیست. مطالعه ما دارای چندین محدودیت است. کیفیت مطالعات متفاوت بود. تصادفی بودن در تمام آزمایشات کافی بود؛ با این حال، 4 مقاله دوسوکور ، یک مقاله یکسوکور و 4مقاله کورسازی را ذکر نکرده بودند. تعداد نمونه در مطالعات مختلفی که در این کار استفاده شده اند بجز دو مورد کم بودند. از طرفی مطالعه ی (Elder et al., 2006) و (Hyman et al., 2016a)  فاقد گروه کنترل بودند. همچنین در مطالعه ی (Whiteley et al., 2010b) انحراف معیار گزارش نشده بود. از طرفی دوره ی درمان در مطالعه ی (Pusponegoro et al., 2015) هفت روز بود که نسبتا کوتاه می باشد. همچنین ما به متن کامل بعضی از مقالات دسترسی نداشتیم و تعدادی از مقالات مفید حذف شدند. از طرفی اگر مقدار دقیق این رژیم در غذای کودکان مشخص می بود مسلما نتایج دقیق تر می شد. نتیجه تا کنون 10 سیستماتیک ریویو درباره ی رژیم فاقد گلوتن و کازئین انجام شده است که همگی مفید بودن این رژیم را تایید می کنند ولی نتایج معنادار نبود و علی رغم این که، این پژوهش مفید بودن این رژیم را در کودکان اوتیسمی تقویت می کند با توجه به محدودیت های مطالعات از جمله تعداد نمونه کم در بعضی مطالعات، کوتاه بودن دوره مطالعه و قدیمی بودن بعضی مداخله ها، ارزیابی کامل تری در این زمینه توصیه می گردد. ما در حال حاضر 9 کارآزمایی بالینی را بررسی و وارد متاآنالیز کردیم که با توجه به نتایج مثبتی که گرفتیم آزمایش های کنترل شده تصادفی بیشتر و بزرگتر ضروری است.                                    REFERENCES ADAMS, J., AUDHYA, T., GEIS, E., GEHN, E., FIMBRES, V., POLLARD, E., MITCHELL, J., INGRAM, J., HELLMERS, R. & LAAKE, D. 2018. Comprehensive nutritional and dietary intervention for autism spectrum disorder—A randomized, controlled 12-month trial. Nutrients, 10, 369. CIÉSLIŃSKA, A., KOSTYRA, E. & SAVELKOUL, H. 2017. Treating autism spectrum disorder with gluten-free and casein-free diet: The underlying microbiota-gut-brain axis mechanisms. HSOA Journal of Clinical Immunology and Immunotherapy, 3, -. EL-RASHIDY, O., EL-BAZ, F., EL-GENDY, Y., KHALAF, R., REDA, D. & SAAD, K. 2017. Ketogenic diet versus gluten free casein free diet in autistic children: a case-control study. Metabolic brain disease, 32, 1935-1941. ELDER, J. H., SHANKAR, M., SHUSTER, J., THERIAQUE, D., BURNS, S. & SHERRILL, L. 2006. The gluten-free, casein-free diet in autism: results of a preliminary double blind clinical trial. Journal of autism and developmental disorders, 36, 413-420. HYMAN, S. L., STEWART, P. A., FOLEY, J., CAIN, U., PECK, R., MORRIS, D. D., WANG, H. & SMITH, T. 2016a. The Gluten-Free/Casein-Free Diet: A Double-Blind Challenge Trial in Children with Autism. Journal of Autism and Developmental Disorders, 46, 205-220. HYMAN, S. L., STEWART, P. A., FOLEY, J., PECK, R., MORRIS, D. D., WANG, H. & SMITH, T. 2016b. The gluten-free/casein-free diet: a double-blind challenge trial in children with autism. Journal of autism and developmental disorders, 46, 205-220. JOHNSON, C. R., HANDEN, B. L., ZIMMER, M., SACCO, K. & TURNER, K. 2011a. Effects of Gluten Free / Casein Free Diet in Young Children with Autism: A Pilot Study. Journal of Developmental and Physical Disabilities, 23, 213-225. JOHNSON, C. R., HANDEN, B. L., ZIMMER, M., SACCO, K. & TURNER, K. 2011b. Effects of gluten free/casein free diet in young children with autism: a pilot study. Journal of Developmental and Physical Disabilities, 23, 213-225. KAŁUŻNA-CZAPLIŃSKA, J. & JÓŹWIK-PRUSKA, J. 2016. Nutritional strategies and personalized diet in autism-choice or necessity? Trends in Food Science & Technology, 49, 45-50. KNIVSBERG, A., REICHELT, K., HØIEN, T. & NØDLAND, M. 2002. A randomised, controlled study of dietary intervention in autistic syndromes. Nutritional neuroscience, 5, 251-261. LANGE, K. W., HAUSER, J. & REISSMANN, A. 2015. Gluten-free and casein-free diets in the therapy of autism. Current Opinion in Clinical Nutrition & Metabolic Care, 18, 572-575. MARÍ-BAUSET, S., LLOPIS-GONZÁLEZ, A., ZAZPE, I., MARÍ-SANCHIS, A. & SUÁREZ-VARELA, M. M. 2016. Nutritional Impact of a Gluten-Free Casein-Free Diet in Children with Autism Spectrum Disorder. Journal of Autism and Developmental Disorders, 46, 673-684. MILLWARD, C., FERRITER, M., CALVER, S. J. & CONNELL-JONES, G. G. 2019. WITHDRAWN: Gluten- and casein-free diets for autistic spectrum disorder. Cochrane Database Syst Rev, 4, CD003498. MOHAMMADI, S., DEMEHRI, F. & SAEEDMANESH, M. 2018. The Impact of Manipulation Training of Handedness on Expressive and Receptive Language in Children with Autism Spectrum Disorder. Neuropsychology. MULLOY, A., LANG, R., O’REILLY, M., SIGAFOOS, J., LANCIONI, G. & RISPOLI, M. 2010. Gluten-free and casein-free diets in the treatment of autism spectrum disorders: a systematic review. Research in Autism Spectrum Disorders, 4, 328-339. PEDERSEN, L., PARLAR, S., KVIST, K., WHITELEY, P. & SHATTOCK, P. 2014. Data mining the ScanBrit study of a gluten- and casein-free dietary intervention for children with autism spectrum disorders: behavioural and psychometric measures of dietary response. Nutr Neurosci, 17, 207-13. PIWOWARCZYK, A., HORVATH, A., ŁUKASIK, J., PISULA, E. & SZAJEWSKA, H. 2018. Gluten-and casein-free diet and autism spectrum disorders in children: a systematic review. European journal of nutrition, 57, 433-440. PUSPONEGORO, H. D., ISMAEL, S., FIRMANSYAH, A., SASTROASMORO, S. & VANDENPLAS, Y. 2015. Gluten and casein supplementation does not increase symptoms in children with autism spectrum disorder. Acta Paediatrica, 104, e500-e505. REICHELT, K. & KNIVSBERG, A.-M. 2003. Can the pathophysiology of autism be explained by the nature of the discovered urine peptides? Nutritional Neuroscience, 6, 19-28. SEUNG, H., ROGALSKI, Y., SHANKAR, M. & ELDER, J. 2007. The gluten-and casein-free diet and autism: Communication outcomes from a preliminary double-blind clinical trial. Journal of Medical Speech Language Pathology, 15, 337. WASHNIESKI, G. 2009. Gluten-free and casein-free diets as a form of alternative treatment for autism spectrum disorders. WHITELEY, P., HARACOPOS, D., KNIVSBERG, A.-M., REICHELT, K. L., PARLAR, S., JACOBSEN, J., SEIM, A., PEDERSEN, L., SCHONDEL, M. & SHATTOCK, P. 2010a. The ScanBrit randomised, controlled, single-blind study of a gluten-and casein-free dietary intervention for children with autism spectrum disorders. Nutritional neuroscience, 13, 87-100. WHITELEY, P., HARACOPOS, D., KNIVSBERG, A. M., REICHELT, K. L., PARLAR, S., JACOBSEN, J., SEIM, A., PEDERSEN, L., SCHONDEL, M. & SHATTOCK, P. 2010b. The ScanBrit randomised, controlled, single-blind study of a gluten- and casein-free dietary intervention for children with autism spectrum disorders. Nutr Neurosci, 13, 87-100.    }, Keywords = {}, volume = {2}, Number = {2}, pages = {0-0}, publisher = {}, url = {http://newresearch.medilam.ac.ir/article-1-551-en.html}, eprint = {http://newresearch.medilam.ac.ir/article-1-551-en.docx}, journal = {Technology and Research Information System}, issn = {}, eissn = {}, year = {2019} } @article{ author = {razaghi, marzyeh and Otaghi, Masoumeh and Shohani, Masoumeh}, title = {The Effect of Orem’s Self-Care Program on Adherence to Treatment among the Elderly Patients with Type II Diabetes in Ilam in 2018}, abstract ={in the elderly. The aim of this study is to determine the effect of Orem’s self-care program on the adherence to treatment among the elderly with type II diabetes. Method: This study was a quasi-experimental intervention with control group which was done on 66 patients with type II diabetes. Data collection tools was a four-section questionnaire including demographic information, examining self-care activities, examining adherence to treatment and in the fourth section examining and recognizing Orem. Before the pretest administration, the educational intervention was done for the experiment group and one week and one month after the intervention, the questionnaire was completed by two groups. In this study data were analyzed using SPSS v.20. Findings: the effect of intervention program was significant at the level of 5%. There was a significant difference between the average score of pretest adherence to treatment among the elderly one week and one month after the intervention (p=000). The comparison of mean scores showed that the score of adherence to treatment is significantly better in one month after the intervention compared to one week after, and better in one-week after compared to the pretest (p=000). Conclusion: the present study shows that nurses can employ Orem’s self-care program and play an important role in the adherence of patients with type II diabetes to their treatment.}, Keywords = {Diabetes, Elderly, Self-care}, volume = {2}, Number = {2}, pages = {0-0}, publisher = {}, url = {http://newresearch.medilam.ac.ir/article-1-550-en.html}, eprint = {http://newresearch.medilam.ac.ir/article-1-550-en.docx}, journal = {Technology and Research Information System}, issn = {}, eissn = {}, year = {2019} } @article{ author = {Otaghi, Masoumeh and shirkhani, sedighe and Azadi, Arman and Khorshidi, Ali}, title = {The Relationship between Perception of Futile Care and Moral Distress of Nurses in Critical Care Units of Ilam}, abstract ={Futile care of patients with less than five percent chance of survival places nurses in moral distress conditions. The aim of this study was to determine the relationship between perception of futile care and moral distress in nurses in critical care units Methods: This descriptive-analytic study was performed on 155 nurses in educational hospitals affiliated to Ilam University of Medical Sciences in 2018. This article is adapted from the thesis of the Master's Degree in Nursing, which was approved by the ethics committee of Ilam University of Medical Sciences with ethics code "ir.medilam.rec.1397.68". Data gathering tools were moral distress (MDS-R) and perception of futile care questionnaires. Data were analyzed by linear regression, Pearson’s correlation coefficient, one way ANOVA and independent t-test by SPSS23 software and p=0.05. Results: In majority of the nurses, the levels of Perception of futile care was high (77.8%) and moral distress was moderate (0.54%). Pearson’s correlation coefficient showed a significant relationship between moral distress and perception of frequency of futile care  (r =0.407, p<0.01) as well as perception of intensity of futile care (r =0.381, p<0.01).  Increasing perception of futile care increased moral distress in the nurses (p< 0.05).  Linear regression indicated a significant relationship between moral distress and perception of frequency of futile care (ẞ =0.263, p=0.034) as well as past clinical experience in critical care units (ẞ =0.209, p=0.023). Conclusion: Levels of perception of futile care was high and moral distress was moderate in the nurses. There was direct and significant relationship between moral distress and perception of futile care. Educating professional ethics and taking palliative care can drive nursing from futile to effective care}, Keywords = {Perception of Futile Care, Moral Distress, Nurse, Critical Care Unit}, volume = {2}, Number = {2}, pages = {0-0}, publisher = {}, url = {http://newresearch.medilam.ac.ir/article-1-556-en.html}, eprint = {http://newresearch.medilam.ac.ir/article-1-556-en.docx}, journal = {Technology and Research Information System}, issn = {}, eissn = {}, year = {2019} } @article{ author = {Otaghi, Masoumeh and Tavan, Hamed and Valizadeh, Reza and Sayehmiri, Kourosh and karimi, ahm}, title = {The Factors Effecting on Academic Achievement of Talented Students in Ilam University of Medical Sciences: A Mixed Method Study}, abstract ={}, Keywords = {}, volume = {2}, Number = {2}, pages = {0-0}, publisher = {}, url = {http://newresearch.medilam.ac.ir/article-1-561-en.html}, eprint = {http://newresearch.medilam.ac.ir/article-1-561-en.docx}, journal = {Technology and Research Information System}, issn = {}, eissn = {}, year = {2019} } @article{ author = {tardeh, zaynab}, title = {Evaluation the Effect of Glucocorticoid Injection for Patients with Cervical Discopathy}, abstract ={Context: Degenerative  disk disease is an age related disorder and there is no published guideline for this disorder. Studies showed that intradical corticosteroid injection can relief symptoms in lumbar discopathy but there is no study in cervical discopathy.   Method: This study conducted to evaluate the use of methylprednisolone infusion in cervical discopathy. Patients with symptomatic disk disorder treated with methyl prednisolone and after 1 and 6 month the improvement was assessed. Data were analyzed using Comprehensive SPSS21 software.   Results: 23 patients entered the study with radicular pain that treated with methylprednisolone pulse and assessed vith visual analog scale. Assessement in 1 and 6 month follow up showed 84% and 78% improvement with no complication.   Conclusion: Methyl prednisolonr pulse is an effective with low complication method for cervical discopathy}, Keywords = {cervical discopathy, pain, methylprednisolone}, volume = {2}, Number = {2}, pages = {0-0}, publisher = {}, url = {http://newresearch.medilam.ac.ir/article-1-555-en.html}, eprint = {http://newresearch.medilam.ac.ir/article-1-555-en.docx}, journal = {Technology and Research Information System}, issn = {}, eissn = {}, year = {2019} } @article{ author = {tardeh, zaynab}, title = {Study the Effectiveness of the Endovenous laser treatment for Varicose Veins: A Systematic Review and Meta-Analysis Study}, abstract ={Context: Varicose veins are common problems that change the quality of life. EVLA has been introduced as a noninvasive treatment for varicose veins. The current systematic review and meta-analysis conducted to assess the efficacy of EVLA in treatment of varicose veins. Method: Using the preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines and MeSH keywords search conducted in data bases of PubMed, Scopus, Web of Science, Science Direct, Embase, Springer, CINAHL, Wiley Online Library, Cochrane Library, EBSCO and Google scholar search engine and the reference list of the retrieved papers until April,2019. Heterogeneity among studies was assessed using Cochran's Q test and I2 index and random effects model was used to estimate Odds Ratio(OR). Data were analyzed using Comprehensive SPSS21 software. Results: Success rate of varicose veins was 98.3%(P=0.000). In this study the efficacy of laser have been decreased with increase the follow up duration but was not significant. Rate of paresthesia was 40.9%, then bruising, ecchymosis and induration with rate of 50%, 38%, 17.2% respectively. Conclusion: This study supported effectiveness and safety of endovenous laser ablation in treatment of varicose vein.}, Keywords = {Varicose Vein, Endovenous Laser Ablation, Occlusion, Meta-Analysis}, volume = {2}, Number = {2}, pages = {0-0}, publisher = {}, url = {http://newresearch.medilam.ac.ir/article-1-554-en.html}, eprint = {http://newresearch.medilam.ac.ir/article-1-554-en.docx}, journal = {Technology and Research Information System}, issn = {}, eissn = {}, year = {2019} } @article{ author = {tardeh, zaynab}, title = {Prevalence of Metabolic Syndrome in Patients with Polycystic Ovary Syndrome: A Systematic Review and Meta-analysis study}, abstract ={Context: Polycystic ovary syndrome (PCOS) is an endocrinopathy with unknown pathophysiology in women of reproductive age. Several studies have been conducted to find the prevalence of metabolic syndrome(MetS) in PCOS patients but the results are different. This study conducted to find the prevalence of MetS in PCOS patients using related published data. Method: Current systematic review and meta-analysis study conducted based on preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines. Search conducted using MeSH keywords of metabolic syndrome, Polycystic ovary syndrome, prevalence in databases of PubMed, Scopus, Embase, CINAHL, Web of Science, Cochrane Library, EBSCO and Google scholar search engine and the reference list of the retrieved papers without time limitation until 2018. We used Cochran’s Q test and I2 Index to evaluate heterogeneity among studies and random model effect use to combine the results. Data analysis was performed in Stat ver 11.1. Results: 46 studies involving 8946 patients with PCOS included the final analysis.  Total heterogeneity in the current study was high (I2: 91.43%, P < 0.001). The Prevalence of MetS in PCOS patients was estimated to be 30% (95% CI: 27-33).  Subgroup of analysis based on MetS diagnostic criteria resulted in estimated prevalence of 0.27% (95% CI: 0.18, 0.37), 0.30% (95% CI: 0.27, 0.34), 0.32 (95% CI: 0.25, 0.39), 0.32 (95% CI: 0.27, 0.37) and 0.24 (95% CI: 0.14, 0.34) for IDF, NECP-ATPIII, AHA NHLBI, CDS and unknown criteria respectively. Conclusion: According to prevalence of MetS in PCOS patients, diagnosis of MetS in patients with PCOS to reduce the rate of mortality and morbidity is needed.}, Keywords = {metabolic syndrome, Polycystic ovary syndrome, prevalence}, volume = {2}, Number = {2}, pages = {0-0}, publisher = {}, url = {http://newresearch.medilam.ac.ir/article-1-553-en.html}, eprint = {http://newresearch.medilam.ac.ir/article-1-553-en.docx}, journal = {Technology and Research Information System}, issn = {}, eissn = {}, year = {2019} } @article{ author = {Moayeri, Ardeshir and Mohamadpour, Shahram}, title = {}, abstract ={}, Keywords = {}, volume = {2}, Number = {3}, pages = {0-0}, publisher = {}, url = {http://newresearch.medilam.ac.ir/article-1-723-en.html}, eprint = {http://newresearch.medilam.ac.ir/article-1-723-en.docx}, journal = {Technology and Research Information System}, issn = {}, eissn = {}, year = {2019} } @article{ author = {Sharifi, Ali and Abbasi, Naser}, title = {Production of the product from the combination of Arnbia euchroma plant and van gum}, abstract ={}, Keywords = {}, volume = {2}, Number = {3}, pages = {0-0}, publisher = {}, url = {http://newresearch.medilam.ac.ir/article-1-719-en.html}, eprint = {}, journal = {Technology and Research Information System}, issn = {}, eissn = {}, year = {2019} } @article{ author = {Basati, Gholam and Shiri, Sabah}, title = {Ultrasonic-assisted green liquid extraction micro-extraction method based on solvent-based polymer nanoparticles for kinematic, ferulic, gallic acid and rutin measurements in olive, almond and sesame oil samples by HPLC-UV}, abstract ={Abstrac A novel, simple, sensitive and green ultrasonic-assisted liquid–liquid microextraction method based on a synthetic citric acid–glycerol nanopolymer solution was used for the extraction of antioxidant acids (ferulic, cinnamic, gallic acid and rutin) in five kinds of oil samples from vegetables. The synthetic nanopolymer from citric acid and glycerol with absolute molar ratio was synthesized, and its specifications were characterized by (FTIR, DLS, GPC, AFM and NMR). Its solution as a green extractor for oil samples was added to n-hexane containing analytes. Then, the extraction was speeded up by using ultrasonic. After the extraction, phase separation (rich phase/n-hexane phase) was accomplished by using a centrifugation. Rich phase in lower phase was removed by a micro-syringe and injected to reverse-phase HPLC with UV detector. Volume of nanopolymer solution, concentration of nanopolymer, extraction time and temperature of ultrasonic bath were optimum conditions and obtained by response surface methodology. This method has good linear calibration ranges between 0.7 and 1300 μg L−1, coefficients of determination (r2 > 0.9831) and low limits of detection between 0.05 and 0.81 μg L−1. This method was successfully used to determine target analytes in oil samples of olive, almond, sesame, hazelnut and edible with satisfactory inter–intraday precision and recoveries (93t.4–107.1%)..}, Keywords = {Keywords Ultrasonic-assisted liquid–liquid microextraction · Nanopolymer · HPLC · Response surface methodology· Vegetable oils}, volume = {2}, Number = {3}, pages = {0-0}, publisher = {}, url = {http://newresearch.medilam.ac.ir/article-1-722-en.html}, eprint = {http://newresearch.medilam.ac.ir/article-1-722-en.docx}, journal = {Technology and Research Information System}, issn = {}, eissn = {}, year = {2019} } @article{ author = {Shafiei, Elham and Nademi, Arash}, title = {Epidemiological Study on Injuries in Ilam from 2010 to 2017}, abstract ={خلاصه ضرورت اجرای طرح:   سوانح یکی از عمده ترین همه گیری های بیماریهای غیر واگیر در قرن حاضر را تشکیل میدهد و به عنوان اتفاقی  و تصادفی محسوب نمی شوند، بلکه بخشی از بهایی است که انسان به ازاء پیشرفت تکنولوژی می پردازد(1-3). سوانح و حوادث از دیرباز به عنوان یک عامل مخرب و مرگ زا برای انسان شناخته شده است(4).  براساس آمارهای منتشره ضایعات ناشی از حوادث یکی از پنج علت مرگ در گروه های مختلف سنی در کشورهای پیشرفته و درحال پیشرفت می باشد. همچنین هزینه و مخارج ناشی از حوادث بسیار سرسام آور بوده و گذشته از ان سالانه میلیون ها نفر در اثر جراحات ناشی از حوادث دچار انواع معلولیت ها می شوند که این امر باعث از دست رفتن نیروی انسانی فعال به همراه میلیون ها ساعت کار مفید می گردد(5-7). حادثه یک واقعه پیش بینی نشده توسط فرد است که نتیجه اش ضررو زیان قابل تشخیص می باشد و به عبارت دیگر حادثه واقعه ای است غیر منتظره که به وسیله انسان بوجود می آید و نتیجه آن ایجاد آسیب قابل تشخیص است(8). امروزه حوادث به عنوان یک مشکل همه گیر نه تنها درجاده بلکه در خانه، مدرسه، مراکز تفریحی، میادین ورزشی و کارگاه ها مطرح و یکی از معضلات مهم کشورهای صنعتی و در حال توسعه می باشد(9). از این رو حوادث در همه جا خطراتی مانند نقص عضو، ناتوانی، مرگ خصوصا برای کودکان و نوجوانان را در برمیگیرد که بدون برنامه ریزی جدی و کاربردی ممکن است رسیدن به بهداشت و سلامت برای همگان را به مخاطره بیندازد. یکی از مسائل تهدیگر سلامتی در جوامع  کنونی تروماها می باشد. در سال 2000 تروما باعث مرگ ومیر  بیش از 6 میلیون نفر در جهان شده است که حدود 63 درصد از این مرگ ها به علت آسیب های غیر عمدی رخ داده است(10).بالا بودن میزان مرگ ومیر ناشی از سوانح موجب شده تا کشورهای مختلف با مطالعه  ویژگیهای جمعینی به شناسایی علل وزمینه های  بروز حوادث وتدوین پیش گیرانه بپردازد.در ایران یک نظام ملی ثبت تروما وجود ندارد.وقتی ما اطلاعات درستی از چگونگی بروز سوانح نداریم، قطعا نمی توانیم برنامه ریزی درستی جهت پیشگیری ویا درمان عوارض ناشی از آن داشته باشیم.با توجه به نامشخص بودن وضعیت چگونگی بروز سوانح مختلف ودر دسترس نبودن مطالعه ای در این زمینه ، نیاز به مطالعه ای جامع دراین راستا احساس می شود. در صورت تعیین وضعیت وماهیت سوانح در شهر ایلام می توان برنامه ریزی وطراحی راه کارهای مناسب از این گونه حوادث پیشگیری نموده، یا از عوارض احتمالی آنها کاست.[a1]     }, Keywords = {}, volume = {2}, Number = {3}, pages = {0-0}, publisher = {}, url = {http://newresearch.medilam.ac.ir/article-1-715-en.html}, eprint = {http://newresearch.medilam.ac.ir/article-1-715-en.docx}, journal = {Technology and Research Information System}, issn = {}, eissn = {}, year = {2019} } @article{ author = {Tavan, Hamed and Qavam, Samiramis and Sayehmiri, Kourosh}, title = {Comparison of the effectiveness of rosuvastatin and atorvastatin on changes in LDL, triglyceride and HDL by systematic review and meta-analysis}, abstract ={Among cardiovascular diseases, Coronary Artery Disease (CAD) accounts for a large proportion of deaths and disabilities due to cardiovascular disease. Pharmacological, interventional and surgical methods are used to treat coronary artery stenosis (1, 2). One of the methods that has been used in recent years to reduce myocardial necrosis during PCI is the use of statin drugs, especially atorvastatin and rosuvastatin (3, 4). Some experimental studies have shown that the use of atorvastatin reduces myocardial infarction (MI) around non-emergency PCIs (5, 6). On the other hand, a small number of studies have shown that the use of high doses of atorvastatin A single dose of 80 mg or rosvastatin 40 mg one day before PCI also reduced infarction around PCI (7, 8).}, Keywords = {Keywords related to population, disease or problem I: Keywords related to therapeutic intervention, exposure or diagnostic method C: Keywords related to comparisons O: Keywords related to desired outcomes}, volume = {2}, Number = {3}, pages = {0-0}, publisher = {}, url = {http://newresearch.medilam.ac.ir/article-1-714-en.html}, eprint = {http://newresearch.medilam.ac.ir/article-1-714-en.docx}, journal = {Technology and Research Information System}, issn = {}, eissn = {}, year = {2019} } @article{ author = {Azami, Mil}, title = {Seroprevalence of Toxoplasma gondii in women of child–bearing age referred to clinical laboratories in Ilam, western Iran}, abstract ={Background: Primary infection with toxoplasmosis during pregnancy can be transmitted to the fetus and may cause serious complications. Considering the importance of toxoplasmosis, the present study was conducted to determine the seroprevalence of toxoplasma gondii (T.gondii) toxoplasmosis in women of child-bearing age in Ilam. Methods: This cross-sectional study was conducted during April 2015 and March 2017, on women of child-bearing age (15-49 years old) that referred to laboratories in Ilam. Sampling was done based on census. Five milliliter venous blood was collected from each participant and the samples were examined using ELISA method. Statistical analysis was performed using SPSS ver. 17. In the analytical statistics, Kruskal-Wallis and Mann-Whitney tests were used. Results: A total 797 women of child-bearing age with mean age of 29.92 ± 7.23 years were examined in this study. The total seroprevalence of T. gondii was 23.46% (187 cases). The seroprevalence of IgG and IgM antibodies against T. gondii was 23.4% and 0.6%, respectively. The relationship between seroprevalence of IgM antibody and age (P= 0.37), level of education (P= 0.501), occupation (P= 0.20), and residence (P= 0.761) were not significant. The relationship between seroprevalence of IgG antibody and level of education (P= 0.196), occupation (P= 0.711), and residence (P= 0.101) were not significant but it was significantly associated with age (P< 0.001).     Conclusion: The results of this study showed that the seroprevalence of IgG antibody against T. gondii is 23.7%, which is relatively high. Prenatal screening can help to identify susceptible women to T. gondii.}, Keywords = {Toxoplasma Gondii, Women, Reproductive, Antibodies}, volume = {2}, Number = {3}, pages = {0-0}, publisher = {}, url = {http://newresearch.medilam.ac.ir/article-1-721-en.html}, eprint = {http://newresearch.medilam.ac.ir/article-1-721-en.doc}, journal = {Technology and Research Information System}, issn = {}, eissn = {}, year = {2019} } @article{ author = {Azizi, Monireh and Amraei, Mansour and Bakhtiyari, Salar}, title = {Investigating the effect of Crocus sativus L. petal hydroalcoholic extract on inflammatory and enzymatic indices resulting from alcohol use in kidney and liver of male rats}, abstract ={Background: Studies have shown that consumption of high levels of alcohol causes many negative effects on the liver and kidneys where antioxidant ingredients can be a proper solution to reducing the resulting damages. So, the present study investigated the effect of hydroalcoholic extract of Crocus sativus L. (saffron) petal with antioxidant properties on the changes in inflammatory and enzymatic indices resulting from alcohol use in the male rats’ kidney and liver. Materials and methods: After preparing the extract, LD50 was determined and highperformance liquid chromatography (HPLC) was employed to specify the type and the rate of the active ingredients of the extract. Then, 36 male Wistar rats were randomly assigned into six groups (n=6). The first group was only administered with normal saline and the second group only received ethyl alcohol 6 mL/kg/day·BW. The third and the fourth groups received ethyl alcohol 6 mL/kg/day·BW plus 167.5 and 335 mg/kg/day·BW saffron petal extract for 8 weeks. The fifth and the sixth groups received ethyl alcohol 6 mL/kg/day·BW for the first 8 weeks and were subsequently gavage fed on saffron extract for 167.5 and 335 mg/kg/day·BW, respectively, during the next 8 weeks. In the beginning and after the termination of the treatment, blood samples were collected from all rats. Results: The LD50 of the extract was about 670 mg/kg. The HPLC results indicated that the extract contains important antioxidant ingredients. At the end of the study, the serum concentration of the inflammatory indices, renal enzymes, and hepatic enzymes experienced a significant reduction in all of the intervened groups compared to the negative control group (minimum significant difference: P<0.05) except for the treatment group 1. Conclusion: Based on the current results, the extract has a protective effect in a dosagedependent way and greater protective roles were documented}, Keywords = {Crocus sativus L., alcohol, kidney, liver, rat}, volume = {2}, Number = {3}, pages = {0-0}, publisher = {}, url = {http://newresearch.medilam.ac.ir/article-1-727-en.html}, eprint = {http://newresearch.medilam.ac.ir/article-1-727-en.docx}, journal = {Technology and Research Information System}, issn = {}, eissn = {}, year = {2019} } @article{ author = {Sharifi, Ali and Abbasi, Naser}, title = {The Study of the Effectiveness of a Mixture of Arnebia Euochroma and Gum Extract in Animal Oils and Comparing It with Honey in Diabetic Foot Ulcer}, abstract ={One of the most important causes of disability in diabetic patients is diabetic foot ulcers. Native use of medicinal herbs may significantly affect the wound healing process. In this study, a mixture of Arnebia euochroma extracts and essential oil of Pistacia Atlantica in animal oil used for healing diabetic wounds was compared with natural honey. Thirty male Wistar rats weighing 250 g became diabetic. Wounds of equal size were created in their back area and the wound was dressed with a mixture of Arnebia euochroma and essential oil of Pistacia Atlantica in animal oil. Afterward, their recovery process was photographed daily. Finally, when we saw evidence of rats' wound healing; we killed rats and searched tissue granulation and epithelialization process. The study results showed that Arnebia euochroma and gum mixture at a concentration of 5% of animal oils was more effective compared to honey. Local and regional experiences can be a good source to access pharmaceutical products and services for patients, a scientific reason for this study. We found a more effective ointment for wound dressing. It can help diabetic patients. The oral forms of these plants are recommended to be provided.}, Keywords = {Diabetic ulcers, native plants, van gum, Arnbia yochroma}, volume = {2}, Number = {3}, pages = {0-0}, publisher = {}, url = {http://newresearch.medilam.ac.ir/article-1-720-en.html}, eprint = {http://newresearch.medilam.ac.ir/article-1-720-en.docx}, journal = {Technology and Research Information System}, issn = {}, eissn = {}, year = {2019} } @article{ author = {Sharifi, Ali}, title = {Comparison of the Effects of Oral Arnebia Euchroma and Oral ANGIPARS on Wounds in Diabetic Rats}, abstract ={Diabetic foot ulcer is one of the most common causes of amputation and imposes high social costs. The present study was conducted to evaluate the effect of oral arnebia euchroma extract on wounds in diabetic rats and was compared with oral and topical forms of ANGIPARS.Thirty diabetic male Wistar rats were categorized into different groups with similar wounds, and were treated with oral and topical forms of arnebia euchroma extract and ANGIPARS ointment and capsules, and were compared with each other and the control group. The clinical and statistical results indicate the superior effect of oral and topical forms of arnebia euchroma extract in comparison with oral and topical forms of ANGIPARS.The epithelial thickness(F (4.25) = 4189.10, p<0.01) and complete healing time(F (4.25) = 18.01, p<0.01), were respectively calculated. It is recommended that a human study be conducted to determine the level of blood glucose and its effect on TNFa and myeloperoxidase as the factors affecting tissue repair}, Keywords = {Arnebia Euchroma, ANGIPARS, Diabetic Foot}, volume = {2}, Number = {3}, pages = {0-0}, publisher = {}, url = {http://newresearch.medilam.ac.ir/article-1-718-en.html}, eprint = {http://newresearch.medilam.ac.ir/article-1-718-en.docx}, journal = {Technology and Research Information System}, issn = {}, eissn = {}, year = {2019} } @article{ author = {Tavan, Hamed and Shohani, Masoumeh and Kalvandi, Gholamrez}, title = {Biochemical parameters of rickets in iranian children: a systematic review and meta analysis}, abstract ={Rickets or osteoporosis is a bone disease that occurs in infants and children (1-2). In this disease, the baby's bones become soft for a number of reasons. Ricketts cause bone loss and bone growth and increase the risk of bone fractures. The main cause of rickets is vitamin D deficiency, but calcium deficiency is also effective .Numerous studies have been conducted on the causes and symptoms of Rashidism in the world. In order to confirm the results of these studies, a meta-analysis study is necessary. The aim of this study was to determine the causes and symptoms of rickets in Iran and to determine this level in terms of mineral deficiency in the body (Ca, Alk and PO4), age, sex and weight of patients, risk factors through systematic review and meta-analysis.}, Keywords = {Biochemical parameters + rickets in iranian children+ systematic review and meta analysis}, volume = {2}, Number = {3}, pages = {0-0}, publisher = {}, url = {http://newresearch.medilam.ac.ir/article-1-712-en.html}, eprint = {http://newresearch.medilam.ac.ir/article-1-712-en.docx}, journal = {Technology and Research Information System}, issn = {}, eissn = {}, year = {2019} } @article{ author = {Tavan, Hamed and Valizadeh, Reza and Sayehmiri, Kourosh and Shohani, Masoumeh}, title = {Epidemiology of self-immolation in iran:systematic review and meta-analysis}, abstract ={Suicide methods vary in different countries based on culture, symbols, symbols and religion. Successful suicide means gaining his soul and if it leads to death. Suicide is one of the social psychological problems and makes it angry (suicide is common in the age group of 15 to 44 years and is the fourth leading cause of death and the sixth leading cause of disability in the world. Since there are no accurate statistics on the causes of self-immolation in Iran and the incidence of it varies in different regions, so understanding these factors can make it necessary for the medical community in planning for financial reduction. According to numerous studies on types of self-immolation in Iran and in order to confirm the results of these studies, a meta-analysis study is necessary to be accurate and valid is the level of planners and researchers in this field. The aim of this study was to investigate the causes of self-immolation in Iran through systematic review and meta-analysis methods.}, Keywords = {Epidemiology+ self-immolation in iran+systematic review and meta-analysis}, volume = {2}, Number = {3}, pages = {0-0}, publisher = {}, url = {http://newresearch.medilam.ac.ir/article-1-716-en.html}, eprint = {http://newresearch.medilam.ac.ir/article-1-716-en.docx}, journal = {Technology and Research Information System}, issn = {}, eissn = {}, year = {2019} } @article{ author = {Tavan, Hamed and Sayehmiri, Kourosh}, title = {Investigating the Causes of trauma and Its risk factors in iran:a systematic review and meta-analysis}, abstract ={Trauma is one of the leading causes of death and disability in different societies (1). Worldwide, 1.2 million people die each year in road accidents and about 50 million are injured. These figures are projected to increase by about 65% over the next 20 years (1-2). It is estimated that for every death resulting from injuries, 16 cases result in hospitalization and 400 cases require outpatient services or with limited transient activity (2). Accidents are the leading cause of death in trauma (3). In Iran, trauma is one of the most common causes of death (5, 4). Every year, more than 5 million people around the world die from an accident (570 people per hour). In developing countries, trauma is the leading cause of death in adolescents, as well as the cause of disability and economic damage related to the health of these countries (6). Trauma can be divided according to the location of injury such as head trauma, abdominal trauma, etc. Or based on the characteristics of the causative agent of the trauma, such as penetrating abdominal trauma (for example, with a sharp object) or blunt trauma, as well as thermal or compressive trauma (barotrauma), etc. (7). Impenetrable trauma, slow trauma to physical injury. A part of the body indicates that it may have been caused by an accident or physical blow. The term usually refers to traumatic injury. In addition, bruising is the first type of more advanced injury, such as bruises, abrasions, wounds, and bone fractures. Impact injury is different from incision; Injury in which something like a bullet enters the body (8).}, Keywords = {Causes of trauma + risk factors in iran+a systematic review and meta-analysis}, volume = {2}, Number = {3}, pages = {0-0}, publisher = {}, url = {http://newresearch.medilam.ac.ir/article-1-713-en.html}, eprint = {http://newresearch.medilam.ac.ir/article-1-713-en.docx}, journal = {Technology and Research Information System}, issn = {}, eissn = {}, year = {2019} } @article{ author = {Delpisheh, Ali}, title = {Scavenger property effect of organic compound in photocatalytic removal of Reactive Black 5 and Direct Blue 71 dye from aquatic solution by using of Titanium Dioxide Nanoparticle in present UV radiation: kinetic study}, abstract ={}, Keywords = {}, volume = {2}, Number = {4}, pages = {0-0}, publisher = {}, url = {http://newresearch.medilam.ac.ir/article-1-861-en.html}, eprint = {http://newresearch.medilam.ac.ir/article-1-861-en.docx}, journal = {Technology and Research Information System}, issn = {}, eissn = {}, year = {2020} } @article{ author = {Sayehmiri, Kourosh}, title = {}, abstract ={}, Keywords = {}, volume = {2}, Number = {4}, pages = {0-0}, publisher = {}, url = {http://newresearch.medilam.ac.ir/article-1-862-en.html}, eprint = {}, journal = {Technology and Research Information System}, issn = {}, eissn = {}, year = {2020} } @article{ author = {Veisani, Yousef and Delpisheh, Ali and Naserifar, Razi}, title = {Title: Determination of socioeconomic inequality in hypertension disease in Ilam province 2011 -2014}, abstract ={Introduction: The large portion of burden of diseases, especially in the developing countries is attributed to hypertension. Identification of the potential risk factors of hypertension is essential for disease management. In this study we investigated the role of socio economic inequality in the prevalence of hypertension in Ilam Province. Methods: Totally, 690 individuals aged over 15 were enrolled in this cross-sectional study, through systematic random sampling from March 1 to October 30, 2017. Socio-economic status (SES) score was calculated by 7 variables including; age, sex, job, marital status, educational level, and economic status, residency, then, it was divided to five levels. Concentration index was used to estimate the inequality in hypertension. To estimate the percentage contribution in final step elasticity divided to concentration index for each contributor and contributions to inequality is estimated. Results: The concentration index for hypertension was -0.154 95% CI (-0.02, -0.23), therefore hypertension was more prevalent in lower socioeconomic groups. The important socioeconomic contributors in inequality were job (P=0.008), educational level (P=0.005), and SES (P=0.003). According to concentration index decomposition, the main sources of inequality in hypertension were job (15%), educational level (18%), and SES (21%), respectively. Conclusion: Hypertension is more prevalent in lower SES groups and the job, education, and SES are important contributory factors of inequality. One substantial key point to achieve an effectiveness approach to deal with chronic diseases might be building partnership with disadvantaged populations.}, Keywords = {Hypertension. Prevalence. Socioeconomic Factors}, volume = {2}, Number = {4}, pages = {0-0}, publisher = {}, url = {http://newresearch.medilam.ac.ir/article-1-856-en.html}, eprint = {http://newresearch.medilam.ac.ir/article-1-856-en.docx}, journal = {Technology and Research Information System}, issn = {}, eissn = {}, year = {2020} } @article{ author = {Naserifar, Razi and Najafi, Azar and Abdi, Jahangir}, title = {Molecular identification of Entamoeba histolytica from stool samples of Ilam}, abstract ={Introduction: Amoebiasis is a multifactorial, life-threatening public health issue and presumably the third parasitic disease cause of mortality - world wide,The aim of this study identified  of  E. histolytica in  from stool samples isolated from Central laboratory and in Imam -Khomeini hospital at the University of Medical Sciences ,and Ilam city which is located in southwest Iran, from 2017 to 2018. Materials and Methods: Totally,2023 samples were examined with microscopy, and Thirty-duplicated Entamoeba histolytica/ dispar isolates were collected from hospital in Ilam, Iran. The isolates were identified and the polymerase chain reaction (PCR) was performed to detect the CP8 gene. Results: In genotype confirmation,  only were two isolates - the CP8  gene found in the PCR test. The sequencing results confirmed the afro-mentioned gene with 97% specifity. Conclusion: It is concluded that PCR are highly sensitive to detect Entamoeba histolytica  and play a fundamental  role as screening tools in direct DNA extraction from stool samples in early detection of symptomatic and asymptomatic E. histolytica patients.}, Keywords = {Entamoeba histolytica , Identification, PCR ,western Iran}, volume = {2}, Number = {4}, pages = {0-0}, publisher = {}, url = {http://newresearch.medilam.ac.ir/article-1-726-en.html}, eprint = {http://newresearch.medilam.ac.ir/article-1-726-en.docx}, journal = {Technology and Research Information System}, issn = {}, eissn = {}, year = {2020} } @article{ author = {Ahmadi, Iraj}, title = {Evaluation of toxic effects of methamphetamine on liver, kidney and blood count}, abstract ={امروزه افزایش مصرف متامفتامین، دارا بودن پتانسیل بالا برای ایجاد اعتیاد و هم چنین ساده بودن پروسه ی تولید آن، زنگ خطری است که جوامع انسانی را تهدید می کند. تخمین زده می شود که حدودا 35 میلیون نفر در دنیا مواد مخدر آمفتامینی مصرف می¬کنند، که این رقم دو برابر مصرف کنندگان کوکائین و بیشتر از سه برابر مصرف کنندگان ماده افیونی )مخدرهای تریاک، مورفین، هروئین، کدئین، متادون و چندین مخدر دیگر که از آن به دست می آید) در سراسر دنیا می باشد(3) . بنابر گزارش اتحادیه جهانی مواد مخدر و جرائم  (UNODC)مقدار توقیف آمفتامین و متامفتامین توسط نیروهای امنیتی در سرتاسر دنیا از سال 2009 تا 2011 دو برابر شده است. که این رقم از 72 تن به 144 تن تغییر کرده و حتی در سال 2014 این مقدار به 173 تن رسیده است. این روند افزایش مقدار توقیف مواد مخدر احتمالا با افزایش تولید و مصرف آن در دنیا رابطه مستقیمی دارد(4).}, Keywords = {Matt amphetamine}, volume = {2}, Number = {4}, pages = {0-0}, publisher = {}, url = {http://newresearch.medilam.ac.ir/article-1-863-en.html}, eprint = {http://newresearch.medilam.ac.ir/article-1-863-en.docx}, journal = {Technology and Research Information System}, issn = {}, eissn = {}, year = {2020} } @article{ author = {hasanvand, fateme and Otaghi, Masoumeh and Mozafari, Mosayeb and Khorshidi, Ali}, title = {The effect of fatigue management by home-based exercise program on the quality of life in patients with cancer}, abstract ={Introduction: Cancer and its treatments lead to various complications such as fatigue, which is one of the most common and most annoying complications in patients with cancer. Extreme fatigue may have a significant im­pact on daily performance and quality of life. Accordingly, this study aimed to investigate the effects of home-based walking program on fatigue in patients with cancer in Ilam in 2018. Methodology: This was an experimental study, which was conducted on 95 patients with cancer; they were random­ly assigned to two groups: A (visited on even days) and B (visited on odd days). The experimental group performed the home-based walking program 3 times a week for 12 weeks. The control group only performed its routine ac­tivities. The patients were followed up. The research tools included demographic information and Multi-dimensional Fatigue Questionnaire (MFI). The fatigue was measured at week 12th. The data was analyzed using independent and paired t-test and chi-square. Findings: After the intervention, the mean score of fa­tigue in the experimental group (35.52±5.68) was signifi­cantly lower than control group (84.68±7.96) (p<0.001). Besides, following the intervention, the mean score of fatigue in the experimental group (35.52±5.68) was sig­nificantly lower than before the intervention (84.28±7.17) (p<0.001). Conclusion: As a simple and low-cost exercise program, walking can reduce the fatigue in patients with cancer; it also plays an effective role in improving the health and rehabilitation of these patients. Keywords: Fatigue, cancer, walking program, home-based exercise. Resumen: Introducción: el cáncer y sus tratamientos con­ducen a diversas complicaciones, como la fatiga, que es una de las complicaciones más comunes y molestas en pa­cientes con cáncer. La fatiga extrema puede tener un im­pacto significativo en el rendimiento diario y la calidad de vida. En consecuencia, este estudio tuvo como objetivo in­vestigar los efectos del programa de caminatas en el hogar sobre la fatiga en pacientes con cáncer en Ilam en 2018. Metodología: Este fue un estudio experimental, que se realizó en 95 pacientes con cáncer; se asignaron al azar a dos grupos: A (visitados los días pares) y B (visitados en días impares). El grupo experimental realizó el programa de caminata en el hogar 3 veces a la semana durante 12 semanas. El grupo control solo realizó sus actividades ru­tinarias. Los pacientes fueron seguidos. Las herramientas de investigación incluyeron información demográfica y cuestionario de fatiga multidimensional (IMF). La fatiga se midió en la semana 12. Los datos se analizaron utilizando t-test independiente y pareada y chi-cuadrado. Resultados: Después de la intervención, la puntuación media de fatiga en el grupo experimental (35,52±5,68) fue significativamente más baja que en el grupo control (84,68±7,96) (p<0,001). Además, después de la interven­ción, la puntuación media de fatiga en el grupo experi­mental (35.52±5.68) fue significativamente más baja que antes de la intervención (84.28±7.17) (p <0.001). Conclusión: como un programa de ejercicios simple y de bajo costo, caminar puede reducir la fatiga en pacientes con cáncer; También desempeña un papel eficaz en la me­jora de la salud y la rehabilitación de estos pacientes. Palabras clave: Parto vaginal; Satisfacción; Estudio cua­litativo. Resumen Abstract 285}, Keywords = {}, volume = {2}, Number = {4}, pages = {0-0}, publisher = {}, url = {http://newresearch.medilam.ac.ir/article-1-860-en.html}, eprint = {http://newresearch.medilam.ac.ir/article-1-860-en.docx}, journal = {Technology and Research Information System}, issn = {}, eissn = {}, year = {2020} } @article{ author = {Naserifar, Razi and najafi, azar}, title = {: Isolation and determine genotype of Acanthamoeba from produce soil of haze in Ilam and Mehran city}, abstract ={In recent years, increasing dust phenomenon in the west of Iran has led to social, economic, and health concerns. This study aimed to represent the existence and genotyping of Acanthamoeba spp. in dust phenomenon in Ilam Province, Iran. In this study, 55 dust samples were collected and by targeting the diagnostic fragment 3 region of the 18S rRNA gene, the genotypes were determined. Utilizing the tolerance ability test, the pathogenic potential of all positive isolates was also recognized. Eighteen samples of Acanthamoeba (32.7%) were detected in the sampling areas. According to sequencing analysis, the isolates related to T4 (77.7%) and T2 (22.3%) genotypes were reported. It was revealed by thermo- and osmotolerance tests in which six strains are extremely pathogenic. To our knowledge, the pathogenic Acanthamoeba was potentially isolated initially from dust phenomenon in Ilam Province. Thus, these strains are probably highly virulent, and dusts are possible sources of Acanthamoeba infection in humans}, Keywords = {Acanthamoeba, genotyping, dust, Ilam, Iran}, volume = {2}, Number = {4}, pages = {0-0}, publisher = {}, url = {http://newresearch.medilam.ac.ir/article-1-857-en.html}, eprint = {http://newresearch.medilam.ac.ir/article-1-857-en.docx}, journal = {Technology and Research Information System}, issn = {}, eissn = {}, year = {2020} } @article{ author = {Abdalmahmoodabadi, Khadijeh and MohamadAli, Roozegar and Valizadeh, Rez}, title = {Evaluation of DMFT and CPITN Indices amongUsers of Various Drugs}, abstract ={Background:Due to the fact that addiction, in addition to social and economic problems, can cause serious oral health complications and impose huge costs of treatment and the elimination of oral health problems among addicts, the present study was conducted to investigate DMFT and CPITN indices among drug users in Ilam's addiction treatment center. Methods:The present ecological, descriptive and cross sectional study was conducted in Ilam's addiction center and all people who visited the centers for drug rehabilitation for one month were closely examined and studied. Clinical examinations were performed by the dentist in order to evaluate DMFT and CPITN indices. The collected data was analyzed by SPSS version 18. Fisher's statistical method (Chi-square) was used to examine the individual information and oral indices. Results: Most of the patients were aged between 30 to 40 years and their mean age was 42.16±5.6; the youngest subject was 20 and the eldest was 77 years old, who were addicted to marijuana and opium. 197 (97.5%) male and 5 (2.5%) female subjects were studied. 130 patients (64.5%) were addicted to opium, 26 (12.8%) to heroine, 20 (9.9%), 11 (5.4%) to crack 15 (7.4%) were addicted to marijuana. 147 (73%) of addicts had dyspepsia problem and 98 (48.5%) had severe dental sensitivity. Temporomandibular-joint disorders were observed in 84 (42%) patients; severe gingival bleeding was observed in 42 cases. The mean DMFT index turned out to be 15.8 in this study. The results of this study showed that there is a significant relationship between the type of drug used and the duration of addiction. Drug users in this study had an inappropriate oral and dental health status. Conclusion :Therefore, proper oral health and preventive dental care interventions in addiction are strongly recommended treatment centers.}, Keywords = {DMFT,CPITN,Addiction,Oral health,Drugs.}, volume = {2}, Number = {4}, pages = {0-0}, publisher = {}, url = {http://newresearch.medilam.ac.ir/article-1-504-en.html}, eprint = {http://newresearch.medilam.ac.ir/article-1-504-en.docx}, journal = {Technology and Research Information System}, issn = {}, eissn = {}, year = {2020} } @article{ author = {Tavan, Hamed and Sayehmiri, Kourosh}, title = {The relationship between self-esteem and academic achievement of Iranian nursing and medical sciences students: A meta-analysis letter}, abstract ={}, Keywords = {}, volume = {2}, Number = {4}, pages = {0-0}, publisher = {}, url = {http://newresearch.medilam.ac.ir/article-1-859-en.html}, eprint = {http://newresearch.medilam.ac.ir/article-1-859-en.docx}, journal = {Technology and Research Information System}, issn = {}, eissn = {}, year = {2020} }