Iranian Red Crescent Medical Journal Iranian Red Crescent Medical Journal Iran Red Crescent Med J http://www.ircmj.com 2074-1804 2074-1812 10.5812/ircmj en jalali 2017 6 25 gregorian 2017 6 25 16 8
en 25389497 10.5812/ircmj.9481 Camurati-Engelmann Disease Association With Hypogonadism and Primary Hypothyroidism Camurati-Engelmann Disease Association With Hypogonadism and Primary Hypothyroidism case-report case-report Introduction

Camurati-Engelmann disease (CED) is a rare autosomal dominant disease with various phenotypic expressions. The symptoms usually develop during childhood. The hallmark of the disease is bilateral symmetric diaphyseal hyperostosis of the long bones with progressive involvement of the metaphysis. The epiphysis is strictly spared. The common clinical symptoms are pain of the extremities, muscle wasting, waddling gait, and lethargy. CED is rarely seen in conjunction with hypogonadism. CED-associated hypothyroidism has not been reported yet. Clinical assessment and skeletal survey are important to make the diagnosis.

Case Presentation

Hereby we reported a case of CED with concomitant hypogonadism and hypothyroidism. Serial plain radiographs of the patient showed classic and progressive diaphyseal cortical hyperostosis of the long bone.

Conclusions

Hyperostosis of the skull was observed in the present case. The characteristic osseous changes of CED were highlighted and the differential diagnoses were discussed.

Introduction

Camurati-Engelmann disease (CED) is a rare autosomal dominant disease with various phenotypic expressions. The symptoms usually develop during childhood. The hallmark of the disease is bilateral symmetric diaphyseal hyperostosis of the long bones with progressive involvement of the metaphysis. The epiphysis is strictly spared. The common clinical symptoms are pain of the extremities, muscle wasting, waddling gait, and lethargy. CED is rarely seen in conjunction with hypogonadism. CED-associated hypothyroidism has not been reported yet. Clinical assessment and skeletal survey are important to make the diagnosis.

Case Presentation

Hereby we reported a case of CED with concomitant hypogonadism and hypothyroidism. Serial plain radiographs of the patient showed classic and progressive diaphyseal cortical hyperostosis of the long bone.

Conclusions

Hyperostosis of the skull was observed in the present case. The characteristic osseous changes of CED were highlighted and the differential diagnoses were discussed.

Camurati-Engelmann Syndrome;Hyperostosis;Primary Hypothyroidism Camurati-Engelmann Syndrome;Hyperostosis;Primary Hypothyroidism http://www.ircmj.com/index.php?page=article&article_id=9481 Soo Fin Low Soo Fin Low Department of Radiology, University Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia; Department of Radiology, University Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia. Tel: +60-391456194, Fax: +60-391456682 Department of Radiology, University Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia; Department of Radiology, University Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia. Tel: +60-391456194, Fax: +60-391456682 Norzailin Abu Bakar Norzailin Abu Bakar Department of Radiology, University Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia Department of Radiology, University Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia Ngiu Chai Soon Ngiu Chai Soon Department of Medicine, University Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia Department of Medicine, University Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
en 25389483 10.5812/ircmj.17175 Aspirin and Preeclampsia Prevention in Patients With Abnormal Uterine Artery Blood Flow Aspirin and Preeclampsia Prevention in Patients With Abnormal Uterine Artery Blood Flow research-article research-article Background

Preeclampsia is one of the leading causes of maternal mortality and morbidity. Its prevalence varies between 10-25% among high-risk pregnant patients.

Objectives

The aim of this study was to determine whether treatment with acetylsalicylic acid (ASA) reduces the incidence of preeclampsia among pregnant women with abnormal uterine artery flow.

Patients and Methods

In this double-blind, placebo controlled trial, 80 high-risk pregnant women with preeclampsia, who had abnormal findings on Doppler ultrasonography at 12-16 weeks of pregnancy (unilateral notch with RI ≥ 0.65 or bilateral notch with RI ≥ 0.55), were randomly divided into two groups; the intervention group was treated with ASA tablet 80 mg, one tablet per day, and the control group was given placebo. Then patients were followed until the end of their pregnancy period, and pregnancy outcomes, including development of preeclampsia, the intrauterine growth retardation (IUGR), prematurity, type of delivery, birth weight, and Apgar score at one and five minutes were assessed. Data were analyzed using the student's t-test, chi-square or Fisher's exact test, and multivariate logistic regression. P values less than 0.05 were considered statistically significant.

Results

There were no significant differences between the two groups in terms of baseline characteristics. There was a significant difference between the ASA and placebo groups in the incidence of preeclampsia (2.5% versus 22.5%), adjusting for the neonatal and maternal covariates.

Conclusions

ASA prophylaxis can be used for prevention of preeclampsia in high-risk patients with abnormal uterine artery.

Background

Preeclampsia is one of the leading causes of maternal mortality and morbidity. Its prevalence varies between 10-25% among high-risk pregnant patients.

Objectives

The aim of this study was to determine whether treatment with acetylsalicylic acid (ASA) reduces the incidence of preeclampsia among pregnant women with abnormal uterine artery flow.

Patients and Methods

In this double-blind, placebo controlled trial, 80 high-risk pregnant women with preeclampsia, who had abnormal findings on Doppler ultrasonography at 12-16 weeks of pregnancy (unilateral notch with RI ≥ 0.65 or bilateral notch with RI ≥ 0.55), were randomly divided into two groups; the intervention group was treated with ASA tablet 80 mg, one tablet per day, and the control group was given placebo. Then patients were followed until the end of their pregnancy period, and pregnancy outcomes, including development of preeclampsia, the intrauterine growth retardation (IUGR), prematurity, type of delivery, birth weight, and Apgar score at one and five minutes were assessed. Data were analyzed using the student's t-test, chi-square or Fisher's exact test, and multivariate logistic regression. P values less than 0.05 were considered statistically significant.

Results

There were no significant differences between the two groups in terms of baseline characteristics. There was a significant difference between the ASA and placebo groups in the incidence of preeclampsia (2.5% versus 22.5%), adjusting for the neonatal and maternal covariates.

Conclusions

ASA prophylaxis can be used for prevention of preeclampsia in high-risk patients with abnormal uterine artery.

Pre-Eclampsia;Blood Flow;Prevention;ASA Pre-Eclampsia;Blood Flow;Prevention;ASA http://www.ircmj.com/index.php?page=article&article_id=17175 Hamidreza Talari Hamidreza Talari Department of Radiology, Kashan University of Medical Sciences, Kashan, IR Iran; Anatomy Research Center, Kashan University of Medical Sciences, Kashan, IR Iran Department of Radiology, Kashan University of Medical Sciences, Kashan, IR Iran; Anatomy Research Center, Kashan University of Medical Sciences, Kashan, IR Iran Elahe Mesdaghinia Elahe Mesdaghinia Trauma Research Center, Kashan University of Medical Sciences, Kashan, IR Iran; Department of Obstetrics Gynecology, Kashan University of Medical Sciences, Kashan, IR Iran; Department of Obstetrics Gynecology, Kashan University of Medical Sciences, Kashan, IR Iran. Tel/Fax: +98-3615620634 Trauma Research Center, Kashan University of Medical Sciences, Kashan, IR Iran; Department of Obstetrics Gynecology, Kashan University of Medical Sciences, Kashan, IR Iran; Department of Obstetrics Gynecology, Kashan University of Medical Sciences, Kashan, IR Iran. Tel/Fax: +98-3615620634 Masoumeh Abedzadeh Kalahroudi Masoumeh Abedzadeh Kalahroudi Trauma Nursing Research Center, Kashan University of Medical Sciences, Kashan, IR Iran; Department of Midwifery, Kashan University of Medical Sciences, Kashan, IR Iran Trauma Nursing Research Center, Kashan University of Medical Sciences, Kashan, IR Iran; Department of Midwifery, Kashan University of Medical Sciences, Kashan, IR Iran
en 25389488 10.5812/ircmj.19282 Comorbidity and Pattern of Substance Use in Hospitalized Psychiatric Patients Comorbidity and Pattern of Substance Use in Hospitalized Psychiatric Patients research-article research-article Background

Substance use in patients with psychiatric disorder is an every-day seen. Detection of this comorbidity can significantly affect the treatment of these disorders, as well as substance use.

Objectives

This study has been conducted to determine the prevalence and pattern of substance use in hospitalized psychiatric patients.

Patients and Methods

In this cross-sectional study, 210 hospitalized psychiatric patients were selected by simple randomization from all records of hospitalized patients. The instrument of gathering data was a demographic checklist including age, gender, marital status, education, type of disorder and substance abuse and duration of psychiatric disorder. Data were analyzed by SPSS version 16 using Fisher exact and Chi square tests.

Results

The mean age of patients was 37.9 years. Most of the patients were male, married and unemployed. The Prevalence of substance use was 36.7%. The most prevalent pattern of substance use was opium, opioid, methamphetamines and other substances (poly substance). The prevalence of substance use in patients with mood disorders was more than the other disorders and the most prevalent substance use in these patients was opium and opioid. Poly substance use was the most prevalent pattern of use (80 %) in psychotic and mood disorders due to substance. Significant difference was seen between genders, marital status, occupation, duration of illness and frequency of substance use (P < 0.05 ), however no significant difference was seen between educational levels, age and substance use.

Conclusions

The patients with mood disorders had the highest comorbidity with substance use and concurrent use of poly substance was the most prevalent pattern of use in these patients. Therefore, successful treatment of psychiatric disorders and substance use needs multimodal and more serious interventions. Regarding to the pattern of poly substance use in these patients, careful screening should be performed at admission.

Background

Substance use in patients with psychiatric disorder is an every-day seen. Detection of this comorbidity can significantly affect the treatment of these disorders, as well as substance use.

Objectives

This study has been conducted to determine the prevalence and pattern of substance use in hospitalized psychiatric patients.

Patients and Methods

In this cross-sectional study, 210 hospitalized psychiatric patients were selected by simple randomization from all records of hospitalized patients. The instrument of gathering data was a demographic checklist including age, gender, marital status, education, type of disorder and substance abuse and duration of psychiatric disorder. Data were analyzed by SPSS version 16 using Fisher exact and Chi square tests.

Results

The mean age of patients was 37.9 years. Most of the patients were male, married and unemployed. The Prevalence of substance use was 36.7%. The most prevalent pattern of substance use was opium, opioid, methamphetamines and other substances (poly substance). The prevalence of substance use in patients with mood disorders was more than the other disorders and the most prevalent substance use in these patients was opium and opioid. Poly substance use was the most prevalent pattern of use (80 %) in psychotic and mood disorders due to substance. Significant difference was seen between genders, marital status, occupation, duration of illness and frequency of substance use (P < 0.05 ), however no significant difference was seen between educational levels, age and substance use.

Conclusions

The patients with mood disorders had the highest comorbidity with substance use and concurrent use of poly substance was the most prevalent pattern of use in these patients. Therefore, successful treatment of psychiatric disorders and substance use needs multimodal and more serious interventions. Regarding to the pattern of poly substance use in these patients, careful screening should be performed at admission.

Mental Disorders;Comorbidity;Substance-Related Disorders Mental Disorders;Comorbidity;Substance-Related Disorders http://www.ircmj.com/index.php?page=article&article_id=19282 Zahra Sepehrmanesh Zahra Sepehrmanesh Department of Psychiatry, Kashan University of Medical Sciences, Kashan, IR Iran Department of Psychiatry, Kashan University of Medical Sciences, Kashan, IR Iran Afshin Ahmadvand Afshin Ahmadvand Department of Psychiatry, Kashan University of Medical Sciences, Kashan, IR Iran; Department of Psychiatry, Kashan University of Medical Sciences, Kashan, IR Iran. Tel: +98-9131625987 Department of Psychiatry, Kashan University of Medical Sciences, Kashan, IR Iran; Department of Psychiatry, Kashan University of Medical Sciences, Kashan, IR Iran. Tel: +98-9131625987 Alireza Moraveji Alireza Moraveji Department of Epidemiology, Kashan University of Medical Sciences, Kashan, IR Iran Department of Epidemiology, Kashan University of Medical Sciences, Kashan, IR Iran
en 25389484 10.5812/ircmj.17799 Comparison of Neurofeedback and Transcutaneous Electrical Nerve Stimulation Efficacy on Treatment of Primary Headaches: A Randomized Controlled Clinical Trial Comparison of Neurofeedback and Transcutaneous Electrical Nerve Stimulation Efficacy on Treatment of Primary Headaches: A Randomized Controlled Clinical Trial research-article research-article Background

Headache is one of the most prevalent investigated complaints in the neurology clinics and is the most common pain-related complaint worldwide. Stress is a significant factor that causes and triggers headaches. Since healthcare practitioners experience a lot of stress in their careers, they are more prone to headaches.

Objectives

This study was designed to evaluate and compares the efficacy of neurofeedback behavioural therapy (NFB) and transcutaneous electrical nerve stimulation (TENS) in the treatment of primary headaches in healthcare providers.

Patients and Methods

The current study was a clinical trial, performed in Teheran, IR Iran, with two experimental groups and a control group. Convenient sampling method was used to recruit patients. Independent variables were NFB and TENS and dependent variables were frequency, severity, and duration of headache. Blanchard headache diary was used for assessment. Hence, 45 healthcare providers with primary headache were selected and randomly allocated to one of the NFB, TENS, and control groups by block random assignment method. All three groups completed the headache diary during one week before and after the treatment period as pretest and posttests, respectively. The NFB group was treated in the period between pretest and posttest with fifteen 30-minute treatment sessions three times a week and the TENS group was treated with fifteen 20-minute daily sessions. The control group received none of these treatments.

Results

The results from the analysis of covariance showed that treatment with NFB and TENS had caused significant decrease in the frequency, severity, and duration of headache in experimental groups. The results of the LSD post-hoc test indicated that there were significant differences in the frequency, severity, and duration of pain among experimental groups and the control group. Moreover, there were significant differences between pain frequencies in experimental groups.

Conclusions

According to the results and given the significant reductions in the frequency, severity, and duration of headaches, it seems that NFB and TENS might have an effective role in reducing primary headaches of healthcare providers. In addition, comparing the two methods, treatment with NFB was more effective in reducing headache frequency and severity.

Background

Headache is one of the most prevalent investigated complaints in the neurology clinics and is the most common pain-related complaint worldwide. Stress is a significant factor that causes and triggers headaches. Since healthcare practitioners experience a lot of stress in their careers, they are more prone to headaches.

Objectives

This study was designed to evaluate and compares the efficacy of neurofeedback behavioural therapy (NFB) and transcutaneous electrical nerve stimulation (TENS) in the treatment of primary headaches in healthcare providers.

Patients and Methods

The current study was a clinical trial, performed in Teheran, IR Iran, with two experimental groups and a control group. Convenient sampling method was used to recruit patients. Independent variables were NFB and TENS and dependent variables were frequency, severity, and duration of headache. Blanchard headache diary was used for assessment. Hence, 45 healthcare providers with primary headache were selected and randomly allocated to one of the NFB, TENS, and control groups by block random assignment method. All three groups completed the headache diary during one week before and after the treatment period as pretest and posttests, respectively. The NFB group was treated in the period between pretest and posttest with fifteen 30-minute treatment sessions three times a week and the TENS group was treated with fifteen 20-minute daily sessions. The control group received none of these treatments.

Results

The results from the analysis of covariance showed that treatment with NFB and TENS had caused significant decrease in the frequency, severity, and duration of headache in experimental groups. The results of the LSD post-hoc test indicated that there were significant differences in the frequency, severity, and duration of pain among experimental groups and the control group. Moreover, there were significant differences between pain frequencies in experimental groups.

Conclusions

According to the results and given the significant reductions in the frequency, severity, and duration of headaches, it seems that NFB and TENS might have an effective role in reducing primary headaches of healthcare providers. In addition, comparing the two methods, treatment with NFB was more effective in reducing headache frequency and severity.

Primary Headache;Healthcare Providers;Neurofeedback;Transcutaneous Electrical Nerve Stimulation Primary Headache;Healthcare Providers;Neurofeedback;Transcutaneous Electrical Nerve Stimulation http://www.ircmj.com/index.php?page=article&article_id=17799 Davood Moshkani Farahani Davood Moshkani Farahani Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences, Teheran, IR Iran; Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences, Teheran, IR Iran. Tel: +98-2144813175, Fax: +98-2144813175 Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences, Teheran, IR Iran; Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences, Teheran, IR Iran. Tel: +98-2144813175, Fax: +98-2144813175 Seyed Abbas Tavallaie Seyed Abbas Tavallaie Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences, Teheran, IR Iran Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences, Teheran, IR Iran Khodabakhsh Ahmadi Khodabakhsh Ahmadi Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences, Teheran, IR Iran Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences, Teheran, IR Iran Ali Fathi Ashtiani Ali Fathi Ashtiani Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences, Teheran, IR Iran Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences, Teheran, IR Iran
en 10.5812/ircmj.20072 Factors Affecting Intensive Care Units Nursing Workload Factors Affecting Intensive Care Units Nursing Workload research-article research-article Conclusions

The nursing workload is influenced by many factors. The clear responsibilities and authorities of nurses, patients' admission according to the capacity of wards, use of the new technologies and equipment, and providing basic training for new nurses can decrease the workload of nurses.

Results

Twenty-five factors were divided into three major categories through EFA, including structure, process, and activity. The following factors among the structure, process and activity components had the greatest importance: lack of clear responsibilities and authorities and performing unnecessary tasks (by a coefficient of 0.709), mismatch between the capacity of wards and the number of patients (by a coefficient of 0.639), and helping the students and newly employed staff (by a coefficient of 0.589).

Background

The nursing workload has a close and strong association with the quality of services provided for the patients. Therefore, paying careful attention to the factors affecting nursing workload, especially those working in the intensive care units (ICUs), is very important.

Objectives

This study aimed to determine the factors affecting nursing workload in the ICUs of the hospitals affiliated to Tehran University of Medical Sciences.

Materials and Methods

This was a cross-sectional and analytical-descriptive study that has done in Iran. All nurses (n = 400) who was working in the ICUs of the hospitals affiliated to Tehran University of Medical Sciences in 2014 were selected and studied using census method. The required data were collected using a researcher–made questionnaire which its validity and reliability were confirmed through getting the opinions of experts and using composite reliability and internal consistency (α = 0.89). The collected data were analyzed through exploratory factor analysis (EFA), confirmatory factor analysis (CFA) and using SPSS 18.0 and AMOS 18.0.

Conclusions

The nursing workload is influenced by many factors. The clear responsibilities and authorities of nurses, patients' admission according to the capacity of wards, use of the new technologies and equipment, and providing basic training for new nurses can decrease the workload of nurses.

Results

Twenty-five factors were divided into three major categories through EFA, including structure, process, and activity. The following factors among the structure, process and activity components had the greatest importance: lack of clear responsibilities and authorities and performing unnecessary tasks (by a coefficient of 0.709), mismatch between the capacity of wards and the number of patients (by a coefficient of 0.639), and helping the students and newly employed staff (by a coefficient of 0.589).

Background

The nursing workload has a close and strong association with the quality of services provided for the patients. Therefore, paying careful attention to the factors affecting nursing workload, especially those working in the intensive care units (ICUs), is very important.

Objectives

This study aimed to determine the factors affecting nursing workload in the ICUs of the hospitals affiliated to Tehran University of Medical Sciences.

Materials and Methods

This was a cross-sectional and analytical-descriptive study that has done in Iran. All nurses (n = 400) who was working in the ICUs of the hospitals affiliated to Tehran University of Medical Sciences in 2014 were selected and studied using census method. The required data were collected using a researcher–made questionnaire which its validity and reliability were confirmed through getting the opinions of experts and using composite reliability and internal consistency (α = 0.89). The collected data were analyzed through exploratory factor analysis (EFA), confirmatory factor analysis (CFA) and using SPSS 18.0 and AMOS 18.0.

Confirmatory Factor Analysis;Nurses;Workload;Intensive Care Units;Iran Confirmatory Factor Analysis;Nurses;Workload;Intensive Care Units;Iran http://www.ircmj.com/index.php?page=article&article_id=20072 Mohammadkarim Bahadori Mohammadkarim Bahadori Health Management Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran Health Management Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran Ramin Ravangard Ramin Ravangard School of Management and Medical Information Sciences, Shiraz University of Medical Sciences, Shiraz, IR Iran School of Management and Medical Information Sciences, Shiraz University of Medical Sciences, Shiraz, IR Iran Mehdi Raadabadi Mehdi Raadabadi Health Services Management Research Center, Kerman University of Medical Sciences, Kerman, IR Iran; Students Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, IR Iran Health Services Management Research Center, Kerman University of Medical Sciences, Kerman, IR Iran; Students Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, IR Iran Seyed Masod Mosavi Seyed Masod Mosavi Hospital Management Research Center, Iran University of Medical Sciences, Tehran, IR Iran Hospital Management Research Center, Iran University of Medical Sciences, Tehran, IR Iran Mohammad Gholami Fesharaki Mohammad Gholami Fesharaki Biostatistic Departmant, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, IR Iran Biostatistic Departmant, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, IR Iran Fardin Mehrabian Fardin Mehrabian School of Health, Guilan University of Medical Sciences, Rasht, IR Iran; School of Health, Guilan University of Medical Sciences, Rasht, IR Iran. Tel: +98-1313229599, Fax: +98-1313234155 School of Health, Guilan University of Medical Sciences, Rasht, IR Iran; School of Health, Guilan University of Medical Sciences, Rasht, IR Iran. Tel: +98-1313229599, Fax: +98-1313234155
en 25389490 10.5812/ircmj.19503 Effects of Wheat Germ Extract on the Severity and Systemic Symptoms of Primary Dysmenorrhea: A Randomized Controlled Clinical Trial Effects of Wheat Germ Extract on the Severity and Systemic Symptoms of Primary Dysmenorrhea: A Randomized Controlled Clinical Trial research-article research-article Conclusions

Wheat germ extract seems to be an effective treatment for dysmenorrhea and its systemic symptoms, probably because of its anti-inflammatory effects.

Results

Pain severity decreased only in the wheat germ extract group (P < 0.001) and there was no statistically significant change in the placebo group. In the wheat germ extract group, the pain severity decreased from 4.701 at baseline to 1.120 at the second cycle. The reduction in total scores of systemic symptoms of dysmenorrhea was statistically significant only in the wheat germ extract group (P < 0.001) and there was not a statistically significant change in the placebo group. It revealed statistically significant differences in systemic symptoms associated with dysmenorrhea including fatigue, headache, and mood swings in experimental group.

Objectives

Considering the anti-inflammatory properties of wheat germ, the present study examined the effects of wheat germ extract on the severity and systemic symptoms of primary dysmenorrhea.

Patients and Methods

This triple-blinded clinical trial was performed on 80 employed women in hospitals affiliated with Hamadan University of Medical Sciences (Hamadan, IR Iran). Subjects were allocated to two groups of 45 patients. Three 400-mg capsules of wheat germ extract or placebo were used daily٫ between the 16th day of the menstrual cycle to the fifth day of the next menstrual cycle for two consecutive months. Pain intensity was measured by a visual analogue scale thrice a day and a four-point verbal rating scale was employed to assess systemic symptoms.

Background

Primary dysmenorrhea is one of the most common disorders in women and the main cause of absenteeism from work and school.

Conclusions

Wheat germ extract seems to be an effective treatment for dysmenorrhea and its systemic symptoms, probably because of its anti-inflammatory effects.

Results

Pain severity decreased only in the wheat germ extract group (P < 0.001) and there was no statistically significant change in the placebo group. In the wheat germ extract group, the pain severity decreased from 4.701 at baseline to 1.120 at the second cycle. The reduction in total scores of systemic symptoms of dysmenorrhea was statistically significant only in the wheat germ extract group (P < 0.001) and there was not a statistically significant change in the placebo group. It revealed statistically significant differences in systemic symptoms associated with dysmenorrhea including fatigue, headache, and mood swings in experimental group.

Objectives

Considering the anti-inflammatory properties of wheat germ, the present study examined the effects of wheat germ extract on the severity and systemic symptoms of primary dysmenorrhea.

Patients and Methods

This triple-blinded clinical trial was performed on 80 employed women in hospitals affiliated with Hamadan University of Medical Sciences (Hamadan, IR Iran). Subjects were allocated to two groups of 45 patients. Three 400-mg capsules of wheat germ extract or placebo were used daily٫ between the 16th day of the menstrual cycle to the fifth day of the next menstrual cycle for two consecutive months. Pain intensity was measured by a visual analogue scale thrice a day and a four-point verbal rating scale was employed to assess systemic symptoms.

Background

Primary dysmenorrhea is one of the most common disorders in women and the main cause of absenteeism from work and school.

Dysmenorrhea;Herbal Medicines;Wheat Germ Dysmenorrhea;Herbal Medicines;Wheat Germ http://www.ircmj.com/index.php?page=article&article_id=19503 Maryam Atallahi Maryam Atallahi Department of Midwifery, Shahid Beheshti University of Medical Sciences, International Branch, Tehran, IR Iran; Faculty of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, IR Iran Department of Midwifery, Shahid Beheshti University of Medical Sciences, International Branch, Tehran, IR Iran; Faculty of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, IR Iran Sedigheh Amir Ali Akbari Sedigheh Amir Ali Akbari Department of Midwifery, Faculty of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran; Department of Midwifery, Faculty of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Vali-asr and Niayesh Junction, Tehran, IR Iran. Tel: +98-9123142669, Fax: +98-2188202512 Department of Midwifery, Faculty of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran; Department of Midwifery, Faculty of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Vali-asr and Niayesh Junction, Tehran, IR Iran. Tel: +98-9123142669, Fax: +98-2188202512 Faraz Mojab Faraz Mojab Department of Pharmacognosy, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Department of Pharmacognosy, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Hamid Alavi Majd Hamid Alavi Majd Department of Biostatistics, Faculty of Paramedicine, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Department of Biostatistics, Faculty of Paramedicine, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
en 25389498 10.5812/ircmj.9531 Giant Fibroadenoma Growing Rapidly During Pregnancy Giant Fibroadenoma Growing Rapidly During Pregnancy case-report case-report Introduction

Giant fibroadenoma is a rare disease with unknown etiology. During pregnancy, fibroadenomas increase in size and may show lactational histologic changes. High concentrations of estrogen, progesterone, and prolactin promote the ductal growth and formation of tubuloalveolar structures. This may be a reason for the significant enlargement in this period.

Case Presentation

We presented a case of giant fibroadenoma, first detected at the onset of pregnancy, which grew rapidly and was excised surgically two months after the birth. There was no marked deformity in the breast nor a need to reconstruct it, despite the giant mass was excised and the mother was lactating.

Discussion

We presented a rare case of giant fibroadenoma in a lactating woman. A progressively growing mass in breast can lead to structural damages. The current management approach for giant fibroadenomas is still surgical excision.

Introduction

Giant fibroadenoma is a rare disease with unknown etiology. During pregnancy, fibroadenomas increase in size and may show lactational histologic changes. High concentrations of estrogen, progesterone, and prolactin promote the ductal growth and formation of tubuloalveolar structures. This may be a reason for the significant enlargement in this period.

Case Presentation

We presented a case of giant fibroadenoma, first detected at the onset of pregnancy, which grew rapidly and was excised surgically two months after the birth. There was no marked deformity in the breast nor a need to reconstruct it, despite the giant mass was excised and the mother was lactating.

Discussion

We presented a rare case of giant fibroadenoma in a lactating woman. A progressively growing mass in breast can lead to structural damages. The current management approach for giant fibroadenomas is still surgical excision.

Fibroadenoma;Phyllodes Tumor;Pregnancy;Lactation Fibroadenoma;Phyllodes Tumor;Pregnancy;Lactation http://www.ircmj.com/index.php?page=article&article_id=9531 Erdal Karagulle Erdal Karagulle Department of General Surgery, Faculty of Medicine, Baskent University, Ankara, Turkey; Department of General Surgery, Faculty of Medicine, Baskent University, Ankara, Turkey. Tel: +90-03322570606, Fax: +90-03322570637 Department of General Surgery, Faculty of Medicine, Baskent University, Ankara, Turkey; Department of General Surgery, Faculty of Medicine, Baskent University, Ankara, Turkey. Tel: +90-03322570606, Fax: +90-03322570637 Emin Turk Emin Turk Department of General Surgery, Faculty of Medicine, Baskent University, Ankara, Turkey Department of General Surgery, Faculty of Medicine, Baskent University, Ankara, Turkey Ozgur Hilal Erinanc Ozgur Hilal Erinanc Department of Pathology, Faculty of Medicine, Baskent University, Ankara, Turkey Department of Pathology, Faculty of Medicine, Baskent University, Ankara, Turkey Gokhan Moray Gokhan Moray Department of General Surgery, Faculty of Medicine, Baskent University, Ankara, Turkey Department of General Surgery, Faculty of Medicine, Baskent University, Ankara, Turkey
en 25389471 10.5812/ircmj.12106 Serum Lectin-Like Oxidized-Low Density Lipoprotein Receptor-1 and Adiponectin Levels Are Associated With Coronary Artery Disease Accompanied With Metabolic Syndrome Serum Lectin-Like Oxidized-Low Density Lipoprotein Receptor-1 and Adiponectin Levels Are Associated With Coronary Artery Disease Accompanied With Metabolic Syndrome research-article research-article Conclusions

Patient with CAD and MS had higher risk than those with only CAD because of lipid and glucose metabolism abnormalities. Combination measurements of serum LOX-1 and adiponectin levels may be helpful to evaluate the severity of CAD together with MS.

Results

Serum LOX-1 level was highest in CAD + MS group; the difference between control and disease groups was statistically significant (P < 0.001). Adiponectin level had the lowest value in CAD + MS group; the difference between control and disease groups was statistically significant (P < 0.05). No significant differences were observed in serum Lectin-like oxidized-low density lipoprotein receptor-1and adiponectin in patients with different ages and gender. Serum LOX-1 level was changed negatively and linearly (R2 = 0.721) correlated with adiponectin level in different groups.

Patients and Methods

Thirty patients with coronary artery disease without metabolic syndrome, 30 patients with coronary artery disease and metabolic syndrome, 30 ones with metabolic syndrome and 30 healthy subjects were enrolled. For all subjects, a questionnaire was filled to collect data, and peripheral blood samples were collected aseptically from the antecubital vein to measure serum Lectin-like oxidized-low density lipoprotein receptor-1 and adiponectin levels by enzyme-linked immunosorbent assay.

Background

Coronary artery disease (CAD) is a major public health problem for developed and developing countries and is the single leading cause of death worldwide.

Objectives

There is very few evidence regarding changes of both serum Lectin-like oxidized-low density lipoprotein receptor-1 (LOX-1) and adiponectin in patients with CAD accompanied with metabolic syndrome (MS). Here we aimed to evaluate serum levels of LOX-1 and adiponectin in patients with CAD accompanied with MS.

Conclusions

Patient with CAD and MS had higher risk than those with only CAD because of lipid and glucose metabolism abnormalities. Combination measurements of serum LOX-1 and adiponectin levels may be helpful to evaluate the severity of CAD together with MS.

Results

Serum LOX-1 level was highest in CAD + MS group; the difference between control and disease groups was statistically significant (P < 0.001). Adiponectin level had the lowest value in CAD + MS group; the difference between control and disease groups was statistically significant (P < 0.05). No significant differences were observed in serum Lectin-like oxidized-low density lipoprotein receptor-1and adiponectin in patients with different ages and gender. Serum LOX-1 level was changed negatively and linearly (R2 = 0.721) correlated with adiponectin level in different groups.

Patients and Methods

Thirty patients with coronary artery disease without metabolic syndrome, 30 patients with coronary artery disease and metabolic syndrome, 30 ones with metabolic syndrome and 30 healthy subjects were enrolled. For all subjects, a questionnaire was filled to collect data, and peripheral blood samples were collected aseptically from the antecubital vein to measure serum Lectin-like oxidized-low density lipoprotein receptor-1 and adiponectin levels by enzyme-linked immunosorbent assay.

Background

Coronary artery disease (CAD) is a major public health problem for developed and developing countries and is the single leading cause of death worldwide.

Objectives

There is very few evidence regarding changes of both serum Lectin-like oxidized-low density lipoprotein receptor-1 (LOX-1) and adiponectin in patients with CAD accompanied with metabolic syndrome (MS). Here we aimed to evaluate serum levels of LOX-1 and adiponectin in patients with CAD accompanied with MS.

LOX-1;Coronary Artery Disease;Adiponectin;Metabolic Syndrome LOX-1;Coronary Artery Disease;Adiponectin;Metabolic Syndrome http://www.ircmj.com/index.php?page=article&article_id=12106 Ali Sheikh Md Sayed Ali Sheikh Md Sayed Department of Cardiology, Xiangya Hospital, Central South University, Changsha, China Department of Cardiology, Xiangya Hospital, Central South University, Changsha, China Zhenyu Zhao Zhenyu Zhao Institute of Clinical Pharmacology, Central South University, Changsha, China Institute of Clinical Pharmacology, Central South University, Changsha, China Lanyan Guo Lanyan Guo Xijing Hospital, Fourth Military Medical University, Xi An, China Xijing Hospital, Fourth Military Medical University, Xi An, China Fei Li Fei Li Department of Cardiology, Xiangya Hospital, Central South University, Changsha, China Department of Cardiology, Xiangya Hospital, Central South University, Changsha, China Xu Deng Xu Deng Department of Cardiology, Xiangya Hospital, Central South University, Changsha, China Department of Cardiology, Xiangya Hospital, Central South University, Changsha, China Hai Deng Hai Deng Department of Cardiology, Xiangya Hospital, Central South University, Changsha, China Department of Cardiology, Xiangya Hospital, Central South University, Changsha, China Ke Xia Ke Xia Department of Cardiology, Xiangya Hospital, Central South University, Changsha, China; Center for Vascular Biology and Inflammation, Cardiovascular Division, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical, Boston, USA; Department of Cardiology, Xiangya Hospital, Central South University, Changsha, China. Tel/Fax: +86-73184327250 Department of Cardiology, Xiangya Hospital, Central South University, Changsha, China; Center for Vascular Biology and Inflammation, Cardiovascular Division, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical, Boston, USA; Department of Cardiology, Xiangya Hospital, Central South University, Changsha, China. Tel/Fax: +86-73184327250 Tianlun Yang Tianlun Yang Department of Cardiology, Xiangya Hospital, Central South University, Changsha, China; Institute of Hypertension, Central South University, Changsha, China; Department of Cardiology, Xiangya Hospital, Central South University, Changsha, China. Tel/Fax: +86-73184327250 Department of Cardiology, Xiangya Hospital, Central South University, Changsha, China; Institute of Hypertension, Central South University, Changsha, China; Department of Cardiology, Xiangya Hospital, Central South University, Changsha, China. Tel/Fax: +86-73184327250
en 25389495 10.5812/ircmj.6243 The Prevalence of Zinc Deficiency in Patients With Thalassemia in South East of Iran, Sistan and Baluchistan Province The Prevalence of Zinc Deficiency in Patients With Thalassemia in South East of Iran, Sistan and Baluchistan Province research-article research-article Background

There are different and controversial reports about zinc deficiency in patients with major thalassemia.

Objectives

The aim of this study was to evaluate zinc status in patients with major thalassemia in Sistan and Baluchistan province, southeastern Iran.

Patients and Methods

The study was performed in Ali Asghar Hospital, a specialized governmental hospital located in Zahedan, Iran. In this cross-sectional study, 369 patients with a history of major thalassemia for more than 5 years entered the study using convenience sampling method. Thirty-six subjects were excluded from the study based on our exclusion criteria. Zinc level was measured in all patients after 12 hours fasting using atomic absorption spectrometry method in 2012.

Results

Of 369 cases, 333 patients were eligible and evaluated. The mean age was 15.63 ± 7.4 years. One hundred ninety two cases were male and others were female (141 cases). About 27% (90) of the cases were 5-10 years-old, 24% (80) were 10-15 years-old and 49% were older than 15 years old. Iron chelator in 65.46% was Desferrioxamine, in 28.2% was Deferasirox and in 19.5% was combination of Desferrioxamine and Deferiprone. All cases had zinc deficiency, and 98.5% had severe zinc deficiency. Others (1.5%) had mild deficiency.

Conclusions

Our study on 333 patients with major thalassemia documented severe zinc deficiency in all cases. We had no cases with normal or increased zinc levels. It was different with other reports in the world.

Background

There are different and controversial reports about zinc deficiency in patients with major thalassemia.

Objectives

The aim of this study was to evaluate zinc status in patients with major thalassemia in Sistan and Baluchistan province, southeastern Iran.

Patients and Methods

The study was performed in Ali Asghar Hospital, a specialized governmental hospital located in Zahedan, Iran. In this cross-sectional study, 369 patients with a history of major thalassemia for more than 5 years entered the study using convenience sampling method. Thirty-six subjects were excluded from the study based on our exclusion criteria. Zinc level was measured in all patients after 12 hours fasting using atomic absorption spectrometry method in 2012.

Results

Of 369 cases, 333 patients were eligible and evaluated. The mean age was 15.63 ± 7.4 years. One hundred ninety two cases were male and others were female (141 cases). About 27% (90) of the cases were 5-10 years-old, 24% (80) were 10-15 years-old and 49% were older than 15 years old. Iron chelator in 65.46% was Desferrioxamine, in 28.2% was Deferasirox and in 19.5% was combination of Desferrioxamine and Deferiprone. All cases had zinc deficiency, and 98.5% had severe zinc deficiency. Others (1.5%) had mild deficiency.

Conclusions

Our study on 333 patients with major thalassemia documented severe zinc deficiency in all cases. We had no cases with normal or increased zinc levels. It was different with other reports in the world.

Thalassemia Major;Zinc;Iran Thalassemia Major;Zinc;Iran http://www.ircmj.com/index.php?page=article&article_id=6243 Mohammad Ali Mashhadi Mohammad Ali Mashhadi Department of Hematology and Oncology, Ali Ebne Abitaleb Hospital, Zahedan University of Medical Sciences, Zahedan, IR Iran Department of Hematology and Oncology, Ali Ebne Abitaleb Hospital, Zahedan University of Medical Sciences, Zahedan, IR Iran Zahra Sepehri Zahra Sepehri Department of Internal Medicine, Amir Al-Momenin Hospital, Zabol University of Medical Sciences, Zabol, IR Iran; Department of Internal Medicine, Amir Al-Momenin Hospital, Zabol University of Medical Sciences, Zabol, IR Iran. Tel: +98-9126880468 Department of Internal Medicine, Amir Al-Momenin Hospital, Zabol University of Medical Sciences, Zabol, IR Iran; Department of Internal Medicine, Amir Al-Momenin Hospital, Zabol University of Medical Sciences, Zabol, IR Iran. Tel: +98-9126880468 Zahra Heidari Zahra Heidari Department of Internal Medicine, Ali Ebne Abitaleb Hospital, Zahedan University of Medical Sciences, Zahedan, IR Iran Department of Internal Medicine, Ali Ebne Abitaleb Hospital, Zahedan University of Medical Sciences, Zahedan, IR Iran Eghbal Shirzaee Eghbal Shirzaee Department of Internal Medicine, Ali Ebne Abitaleb Hospital, Zahedan University of Medical Sciences, Zahedan, IR Iran Department of Internal Medicine, Ali Ebne Abitaleb Hospital, Zahedan University of Medical Sciences, Zahedan, IR Iran Zohre Kiani Zohre Kiani Kerman University of Medical Sciences, Kerman, IR Iran Kerman University of Medical Sciences, Kerman, IR Iran
en 25389482 10.5812/ircmj.16307 Association of Psychologic and Nonpsychologic Factors With Primary Dysmenorrhea Association of Psychologic and Nonpsychologic Factors With Primary Dysmenorrhea research-article research-article Conclusions

Low social support, alexithymia, neuroticism trait, long menstrual bleeding, family history of dysmenorrhea, and high-caffeine diet are important risk factors for women with primary dysmenorrhea. This study recommended considering psychologic factors as an adjuvant to medical risks in evaluation and treatment of primary dysmenorrhea.

Results

The strongest predictor of primary dysmenorrhea was low social support (OR = 4.25; 95% CI, 2.43-7.41). Risk of dysmenorrhea was approximately 3.3 times higher in women with alexithymia (OR = 3.26; 95% CI, 1.88-5.62), 3.1 times higher in women with menstrual bleeding duration ≥ 7 days (OR = 3.06; 95% CI, 1.73-5.41), 2.5 times higher in women with a neurotic character (OR = 2.53; 95% CI, 1.42-4.50), 2.4 times higher in women with a family history of dysmenorrhea (OR = 2.43; 95% CI, 1.42-4.50), and twice higher in women with high caffeine intake (OR = 1.97; 95% CI, 1.09-3.59).

Background

Primary dysmenorrhea seems to be one the most common gynecologic condition in women of childbearing age.

Objectives

The aim of this research was to evaluate psychologic and nonpsychologic risk factors of primary dysmenorrhea.

Materials and Methods

A cross-sectional study was conducted on medical sciences students of Babol University of Medical Sciences. In this study, 180 females with dysmenorrhea and 180 females without dysmenorrhea were enrolled. Psychological risk factors were evaluated in four domains including affect, social support, personality, and alexithymia. Four questionnaires were used to assessed aforementioned domains, namely, Social Support Questionnaire (SSQ), depression, anxiety, stress (DAS-21), 20-item Toronto Alexithymia Scale (TAS-20), and NEO-Five Factor Inventory of Personality (NEO-FFI). In addition, nonpsychologic factors were evaluated in three domains including demographic characteristics, habits, and gynecologic factors. Data were analyzed using the χ2 test and multiple logistic regression analysis.

Conclusions

Low social support, alexithymia, neuroticism trait, long menstrual bleeding, family history of dysmenorrhea, and high-caffeine diet are important risk factors for women with primary dysmenorrhea. This study recommended considering psychologic factors as an adjuvant to medical risks in evaluation and treatment of primary dysmenorrhea.

Results

The strongest predictor of primary dysmenorrhea was low social support (OR = 4.25; 95% CI, 2.43-7.41). Risk of dysmenorrhea was approximately 3.3 times higher in women with alexithymia (OR = 3.26; 95% CI, 1.88-5.62), 3.1 times higher in women with menstrual bleeding duration ≥ 7 days (OR = 3.06; 95% CI, 1.73-5.41), 2.5 times higher in women with a neurotic character (OR = 2.53; 95% CI, 1.42-4.50), 2.4 times higher in women with a family history of dysmenorrhea (OR = 2.43; 95% CI, 1.42-4.50), and twice higher in women with high caffeine intake (OR = 1.97; 95% CI, 1.09-3.59).

Background

Primary dysmenorrhea seems to be one the most common gynecologic condition in women of childbearing age.

Objectives

The aim of this research was to evaluate psychologic and nonpsychologic risk factors of primary dysmenorrhea.

Materials and Methods

A cross-sectional study was conducted on medical sciences students of Babol University of Medical Sciences. In this study, 180 females with dysmenorrhea and 180 females without dysmenorrhea were enrolled. Psychological risk factors were evaluated in four domains including affect, social support, personality, and alexithymia. Four questionnaires were used to assessed aforementioned domains, namely, Social Support Questionnaire (SSQ), depression, anxiety, stress (DAS-21), 20-item Toronto Alexithymia Scale (TAS-20), and NEO-Five Factor Inventory of Personality (NEO-FFI). In addition, nonpsychologic factors were evaluated in three domains including demographic characteristics, habits, and gynecologic factors. Data were analyzed using the χ2 test and multiple logistic regression analysis.

Dysmenorrhea;Alexithymia;Personality Dysmenorrhea;Alexithymia;Personality http://www.ircmj.com/index.php?page=article&article_id=16307 Mahbobeh Faramarzi Mahbobeh Faramarzi Fatemeh Zahra Infertility and Reproductive Health Research Center, Department of Midwifery, Babol University of Medical Sciences, Babol, IR Iran Fatemeh Zahra Infertility and Reproductive Health Research Center, Department of Midwifery, Babol University of Medical Sciences, Babol, IR Iran Hajar Salmalian Hajar Salmalian Fatemeh Zahra Infertility and Reproductive Health Research Center, Department of Midwifery, Babol University of Medical Sciences, Babol, IR Iran; Fatemeh Zahra Infertility and Reproductive Health Research Center, Department of Midwifery, Babol University of Medical Sciences, Babol, IR Iran. Tel: +98-9111122259 Fatemeh Zahra Infertility and Reproductive Health Research Center, Department of Midwifery, Babol University of Medical Sciences, Babol, IR Iran; Fatemeh Zahra Infertility and Reproductive Health Research Center, Department of Midwifery, Babol University of Medical Sciences, Babol, IR Iran. Tel: +98-9111122259
en 25389478 10.5812/ircmj.13628 A Comparison of Second and Third Generations Combined Oral Contraceptive Pills’ Effect on Mood A Comparison of Second and Third Generations Combined Oral Contraceptive Pills’ Effect on Mood research-article research-article Background

Most women taking combined oral contraceptives (COCs) are satisfied with their contraceptive method. However, one of the most common reasons reported for discontinuation of combined oral contraceptives (COCs) is mood deterioration.

Objectives

This study aimed to compare effects of the second and third generation oral contraceptive pills on the mood of reproductive women.

Materials and Methods

This randomized, double-blind, controlled clinical trial was conducted in reproductive women at health centers in Tehran, Iran. Participants were randomized into the second and third generation oral contraceptive groups. Positive and negative moods were recorded using positive affect, negative affect scale (PANAS) tools at the end the second and fourth months of the study. Data analysis was carried out using ANOVA and P Values < 0.05 was considered significant.

Results

Statistically significant difference was seen in positive and negative mood changes in women receiving contraceptive pills. The second generation oral contraceptive pills resulted in a decrease in positive mood (95% CI: 43.39 to 38.32 in second month and 43.39 to 26.05 in four month) and increase in negative mood (95% CI: 14.23 to 22.04 in second month and 14.23 to 32.26 in four month - P < 0.001), but the third generation led to an increase in positive mood (95% CI: 22.42 to 25.60 in second month and 22.42 to 33.87 in four month) and decrease in negative mood (95% CI: 36.78 to 31.97 in second month and 36.78 to 22.65 in four month - P < 0.001).

Conclusions

Third generation combined oral contraceptive pills have a better effect on mood in women in reproductive ages than the second generation pills. It can be recommended as a proper combined oral contraceptive in Iran.

Background

Most women taking combined oral contraceptives (COCs) are satisfied with their contraceptive method. However, one of the most common reasons reported for discontinuation of combined oral contraceptives (COCs) is mood deterioration.

Objectives

This study aimed to compare effects of the second and third generation oral contraceptive pills on the mood of reproductive women.

Materials and Methods

This randomized, double-blind, controlled clinical trial was conducted in reproductive women at health centers in Tehran, Iran. Participants were randomized into the second and third generation oral contraceptive groups. Positive and negative moods were recorded using positive affect, negative affect scale (PANAS) tools at the end the second and fourth months of the study. Data analysis was carried out using ANOVA and P Values < 0.05 was considered significant.

Results

Statistically significant difference was seen in positive and negative mood changes in women receiving contraceptive pills. The second generation oral contraceptive pills resulted in a decrease in positive mood (95% CI: 43.39 to 38.32 in second month and 43.39 to 26.05 in four month) and increase in negative mood (95% CI: 14.23 to 22.04 in second month and 14.23 to 32.26 in four month - P < 0.001), but the third generation led to an increase in positive mood (95% CI: 22.42 to 25.60 in second month and 22.42 to 33.87 in four month) and decrease in negative mood (95% CI: 36.78 to 31.97 in second month and 36.78 to 22.65 in four month - P < 0.001).

Conclusions

Third generation combined oral contraceptive pills have a better effect on mood in women in reproductive ages than the second generation pills. It can be recommended as a proper combined oral contraceptive in Iran.

Mood Disorders; Contraceptive Agents; Administration; Oral Mood Disorders; Contraceptive Agents; Administration; Oral http://www.ircmj.com/index.php?page=article&article_id=13628 Mahnaz Shahnazi Mahnaz Shahnazi Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, IR Iran Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, IR Iran Azizeh Farshbaf Khalili Azizeh Farshbaf Khalili Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, IR Iran Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, IR Iran Fatemeh Ranjbar Kochaksaraei Fatemeh Ranjbar Kochaksaraei Department of Psychiatry, Tabriz University of Medical Sciences, Tabriz, IR Iran Department of Psychiatry, Tabriz University of Medical Sciences, Tabriz, IR Iran Mohammad Asghari Jafarabadi Mohammad Asghari Jafarabadi Department of Biochemistry, Nutrition Therapy, Community Nutrition, School of Health and Nutrition, Tabriz University of Medical Sciences, Tabriz, IR Iran Department of Biochemistry, Nutrition Therapy, Community Nutrition, School of Health and Nutrition, Tabriz University of Medical Sciences, Tabriz, IR Iran Kamal Gaza Banoi Kamal Gaza Banoi Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, IR Iran Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, IR Iran Jila Nahaee Jila Nahaee Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, IR Iran Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, IR Iran Somayeh Bayati Payan Somayeh Bayati Payan Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, IR Iran; Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, IR Iran. Tel: +98-2177956775 Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, IR Iran; Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, IR Iran. Tel: +98-2177956775
en 25389481 10.5812/ircmj.15485 The Effects of Inhalation Aromatherapy on Anxiety in Patients With Myocardial Infarction: A Randomized Clinical Trial The Effects of Inhalation Aromatherapy on Anxiety in Patients With Myocardial Infarction: A Randomized Clinical Trial research-article research-article Conclusions

Inhalation aromatherapy with lavender aroma can reduce anxiety in patients with myocardial infarction. Consequently, healthcare providers, particularly nurses, can use this strategy to improve postmyocardial infarction anxiety management.

Results

The study groups did not differ significantly regarding baseline anxiety mean and demographic characteristics. However, after the administration of aromatherapy, anxiety mean in the experimental group was significantly lower than the control group.

Objectives

The aim of this study was to investigate the effects of inhalation aromatherapy on anxiety in patients with myocardial infarction.

Patients and Methods

This was a randomized clinical trial conduced on 68 patients with myocardial infarction hospitalized in coronary care units of a large-scale teaching hospital affiliated to Kashan University of Medical Sciences, Kashan, Iran in 2013. By using the block randomization technique, patients were randomly assigned to experimental (33 patients receiving inhalation aromatherapy with lavender aroma twice a day for two subsequent days) and control (35 patients receiving routine care of study setting including no aromatherapy) groups. At the beginning of study and twenty minutes after each aromatherapy session, anxiety state of patients was assessed using the Spielberger’s State Anxiety Inventory. Data was analyzed using SPSS v. 16.0. We used Chi-square, Fisher’s exact, independent-samples T-test and repeated measures analysis of variance to analyze the study data.

Background

Anxiety is an important mental health problem in patients with cardiac disease. Anxiety reduces patients’ quality of life and increases the risk of different cardiac complications.

Conclusions

Inhalation aromatherapy with lavender aroma can reduce anxiety in patients with myocardial infarction. Consequently, healthcare providers, particularly nurses, can use this strategy to improve postmyocardial infarction anxiety management.

Results

The study groups did not differ significantly regarding baseline anxiety mean and demographic characteristics. However, after the administration of aromatherapy, anxiety mean in the experimental group was significantly lower than the control group.

Objectives

The aim of this study was to investigate the effects of inhalation aromatherapy on anxiety in patients with myocardial infarction.

Patients and Methods

This was a randomized clinical trial conduced on 68 patients with myocardial infarction hospitalized in coronary care units of a large-scale teaching hospital affiliated to Kashan University of Medical Sciences, Kashan, Iran in 2013. By using the block randomization technique, patients were randomly assigned to experimental (33 patients receiving inhalation aromatherapy with lavender aroma twice a day for two subsequent days) and control (35 patients receiving routine care of study setting including no aromatherapy) groups. At the beginning of study and twenty minutes after each aromatherapy session, anxiety state of patients was assessed using the Spielberger’s State Anxiety Inventory. Data was analyzed using SPSS v. 16.0. We used Chi-square, Fisher’s exact, independent-samples T-test and repeated measures analysis of variance to analyze the study data.

Background

Anxiety is an important mental health problem in patients with cardiac disease. Anxiety reduces patients’ quality of life and increases the risk of different cardiac complications.

Anxiety;Aromatherapy;Lavender;Myocardial Infarction Anxiety;Aromatherapy;Lavender;Myocardial Infarction http://www.ircmj.com/index.php?page=article&article_id=15485 Zahra Najafi Zahra Najafi Department of Health Management, Faculty of Nursing and Midwifery, Kashan University of Medical Sciences, Kashan, IR Iran Department of Health Management, Faculty of Nursing and Midwifery, Kashan University of Medical Sciences, Kashan, IR Iran Mohsen Taghadosi Mohsen Taghadosi Department of Medical Surgical Nursing, Faculty of Nursing, Kashan University of Medical Sciences, Kashan, IR Iran Department of Medical Surgical Nursing, Faculty of Nursing, Kashan University of Medical Sciences, Kashan, IR Iran Khadijeh Sharifi Khadijeh Sharifi Department of Health Management, Faculty of Nursing and Midwifery, Kashan University of Medical Sciences, Kashan, IR Iran Department of Health Management, Faculty of Nursing and Midwifery, Kashan University of Medical Sciences, Kashan, IR Iran Alireza Farrokhian Alireza Farrokhian Department of Internal Medicine, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, IR Iran Department of Internal Medicine, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, IR Iran Zahra Tagharrobi Zahra Tagharrobi Department of Health Management, Faculty of Nursing and Midwifery, Kashan University of Medical Sciences, Kashan, IR Iran; Department of Health Management, Faculty of Nursing and Midwifery, Kashan University of Medical Sciences, Kashan, IR Iran. Tel: +98-9131613899, Fax: +98-3615556633 Department of Health Management, Faculty of Nursing and Midwifery, Kashan University of Medical Sciences, Kashan, IR Iran; Department of Health Management, Faculty of Nursing and Midwifery, Kashan University of Medical Sciences, Kashan, IR Iran. Tel: +98-9131613899, Fax: +98-3615556633
en 25389486 10.5812/ircmj.18399 The Effect of Health Promoting Intervention on Healthy Lifestyle and Social Support in Elders: A Clinical Trial Study The Effect of Health Promoting Intervention on Healthy Lifestyle and Social Support in Elders: A Clinical Trial Study research-article research-article Background

Many of the problems pertaining to old age originate from unhealthy lifestyle and low social support. Overcoming these problems requires precise and proper policy-making and planning.

Objectives

The aim of the current research is to investigate the effect of health promoting interventions on healthy lifestyle and social support in elders.

Patients and Methods

This study was conducted as a clinical trial lasting for 12 months on 464 elders aged above 60 years who were under the aegis of health homes in Tehran, Iran. Participants were selected through double stage cluster sampling and then divided into intervention and control groups (232 individuals in each). Tools for gathering data were a demographic checklist and two standard questionnaires called Health-Promoting Lifestyle Profile version 2 and personal resource questionnaire part 2. Data were analyzed using descriptive and analytical tests including paired t test, analysis of covariance (ANCOVA) and Pearson correlation coefficient.

Results

The average age of elders in this study was 65.9 ± 3.6 years (ranging between 60 and 73 years old). Results showed that the differences between the mean post-test scores of healthy lifestyle and its six dimensions as well as perceived social support and its five dimensions in the control and intervention groups were statistically significant (P value < 0.0001).

Conclusions

Aging is an inevitable stage of life. However, effective health promoting interventions can procrastinate it, reduce its consequences and problems, and turn it into a pleasant and enjoyable part of life.

Background

Many of the problems pertaining to old age originate from unhealthy lifestyle and low social support. Overcoming these problems requires precise and proper policy-making and planning.

Objectives

The aim of the current research is to investigate the effect of health promoting interventions on healthy lifestyle and social support in elders.

Patients and Methods

This study was conducted as a clinical trial lasting for 12 months on 464 elders aged above 60 years who were under the aegis of health homes in Tehran, Iran. Participants were selected through double stage cluster sampling and then divided into intervention and control groups (232 individuals in each). Tools for gathering data were a demographic checklist and two standard questionnaires called Health-Promoting Lifestyle Profile version 2 and personal resource questionnaire part 2. Data were analyzed using descriptive and analytical tests including paired t test, analysis of covariance (ANCOVA) and Pearson correlation coefficient.

Results

The average age of elders in this study was 65.9 ± 3.6 years (ranging between 60 and 73 years old). Results showed that the differences between the mean post-test scores of healthy lifestyle and its six dimensions as well as perceived social support and its five dimensions in the control and intervention groups were statistically significant (P value < 0.0001).

Conclusions

Aging is an inevitable stage of life. However, effective health promoting interventions can procrastinate it, reduce its consequences and problems, and turn it into a pleasant and enjoyable part of life.

Lifestyle;Social support;Health Promotion Lifestyle;Social support;Health Promotion http://www.ircmj.com/index.php?page=article&article_id=18399 Abbas Rahimi Foroushani Abbas Rahimi Foroushani Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, IR Iran Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, IR Iran Fatemeh Estebsari Fatemeh Estebsari Department of Health Education and Promotion, School of Public Health, Iran University of Medical Sciences, Tehran, IR Iran; Department of Health Education and Promotion, School of Public Health, Iran University of Medical Sciences, Tehran, IR Iran. Tel: +98-2188779118, Fax: +98-2188779118 Department of Health Education and Promotion, School of Public Health, Iran University of Medical Sciences, Tehran, IR Iran; Department of Health Education and Promotion, School of Public Health, Iran University of Medical Sciences, Tehran, IR Iran. Tel: +98-2188779118, Fax: +98-2188779118 Davoud Mostafaei Davoud Mostafaei Department of Health Economic and Management, School of Public Health, Tehran University of Medical Sciences, Tehran, IR Iran Department of Health Economic and Management, School of Public Health, Tehran University of Medical Sciences, Tehran, IR Iran Hasan Eftekhar Ardebili Hasan Eftekhar Ardebili Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, IR Iran Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, IR Iran Dvoud Shojaeizadeh Dvoud Shojaeizadeh Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, IR Iran Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, IR Iran Maryam Dastoorpour Maryam Dastoorpour Modeling In Health Research Center, Futures Studies in Health Institute, Kerman University of Medical Sciences, Kerman, IR Iran Modeling In Health Research Center, Futures Studies in Health Institute, Kerman University of Medical Sciences, Kerman, IR Iran Ensiyeh Jamshidi Ensiyeh Jamshidi Community Based Participatory Research Center, Iranian Institute for Reduction of High-risk Behaviors, Tehran University of Medical Sciences, Tehran, IR Iran Community Based Participatory Research Center, Iranian Institute for Reduction of High-risk Behaviors, Tehran University of Medical Sciences, Tehran, IR Iran Mohammad Hossein Taghdisi Mohammad Hossein Taghdisi Department of Health Education and Promotion, School of Public Health, Iran University of Medical Sciences, Tehran, IR Iran Department of Health Education and Promotion, School of Public Health, Iran University of Medical Sciences, Tehran, IR Iran
en 25389472 10.5812/ircmj.12559 Prophylactic Aminophylline for Prevention of Apnea at Higher-Risk Preterm Neonates Prophylactic Aminophylline for Prevention of Apnea at Higher-Risk Preterm Neonates research-article research-article Conclusions

This study supports the preventative effects of aminophylline on apnea in extreme premature infants. In other words, the more premature an infant, the greater the preventative effect of aminophylline on the incidence of apnea and bradycardia.

Background

A few studies have been carried on preventive drugs for apnea of preterm neonates.

Objectives

This study aimed to assess the safety and prophylactic effects of aminophylline on the incidence of apnea in premature neonates.

Patients and Methods

This study was a randomized clinical trial (RCT) research. The prophylactic effect of aminophylline on apnea was investigated in premature babies in our NICU (IRAN-Isfahan). In the study group (A), 5 mg/kg aminophylline was initially administered as a loading dose. Then, every 8 hours, 1.5 mg/kg was given as maintenance dose for the next 10 days. In the control group (C), no aminophylline was used during the first ten days of life.

Results

Fifty-two neonates were randomized for the study and all of them completed it. Primary outcomes were clearly different between the two groups. Only 2 infants (7.7%) who had been placed in aminophylline group developed apnea, as compared to 16 infants (61.5%) in the control group (P < 0.001). Three and four neonates (11.5%, 15.4%) in the aminophylline group developed bradycardia and cyanosis respectively, as compared to 16 infants (61.5%) who did not receive aminophylline (P < 0.001). Median time of need to NCPAP (Nasal Continuous Positive Airway Pressure) was 1 (0 - 4) days and 2.5 (0.5 - 6.5) days in group A and C, respectively (P = 0.03). No side effects were reported in neonates (P > 0.999). Median time of hospitalization was shorter in aminophylline group (P = 0.04).

Conclusions

This study supports the preventative effects of aminophylline on apnea in extreme premature infants. In other words, the more premature an infant, the greater the preventative effect of aminophylline on the incidence of apnea and bradycardia.

Background

A few studies have been carried on preventive drugs for apnea of preterm neonates.

Objectives

This study aimed to assess the safety and prophylactic effects of aminophylline on the incidence of apnea in premature neonates.

Patients and Methods

This study was a randomized clinical trial (RCT) research. The prophylactic effect of aminophylline on apnea was investigated in premature babies in our NICU (IRAN-Isfahan). In the study group (A), 5 mg/kg aminophylline was initially administered as a loading dose. Then, every 8 hours, 1.5 mg/kg was given as maintenance dose for the next 10 days. In the control group (C), no aminophylline was used during the first ten days of life.

Results

Fifty-two neonates were randomized for the study and all of them completed it. Primary outcomes were clearly different between the two groups. Only 2 infants (7.7%) who had been placed in aminophylline group developed apnea, as compared to 16 infants (61.5%) in the control group (P < 0.001). Three and four neonates (11.5%, 15.4%) in the aminophylline group developed bradycardia and cyanosis respectively, as compared to 16 infants (61.5%) who did not receive aminophylline (P < 0.001). Median time of need to NCPAP (Nasal Continuous Positive Airway Pressure) was 1 (0 - 4) days and 2.5 (0.5 - 6.5) days in group A and C, respectively (P = 0.03). No side effects were reported in neonates (P > 0.999). Median time of hospitalization was shorter in aminophylline group (P = 0.04).

Apnea of Prematurity;Premature Infant;Methyl xanthine Therapy;Aminophylline Apnea of Prematurity;Premature Infant;Methyl xanthine Therapy;Aminophylline http://www.ircmj.com/index.php?page=article&article_id=12559 Amir Mohammad Armanian Amir Mohammad Armanian Department of Pediatrics, Child Growth and Development Research Center, Isfahan University of Medical Sciences, Isfahan, IR Iran; Department of Pediatrics, Child Growth and Development Research Center, Isfahan University of Medical Sciences, Isfahan, IR Iran. Tel: 98-9131294044 Department of Pediatrics, Child Growth and Development Research Center, Isfahan University of Medical Sciences, Isfahan, IR Iran; Department of Pediatrics, Child Growth and Development Research Center, Isfahan University of Medical Sciences, Isfahan, IR Iran. Tel: 98-9131294044 Zohreh Badiee Zohreh Badiee Department of Pediatrics, Child Growth and Development Research Center, Isfahan University of Medical Sciences, Isfahan, IR Iran Department of Pediatrics, Child Growth and Development Research Center, Isfahan University of Medical Sciences, Isfahan, IR Iran Raha Afghari Raha Afghari Isfahan University of Medical Sciences, Isfahan, IR Iran Isfahan University of Medical Sciences, Isfahan, IR Iran Nima Salehimehr Nima Salehimehr Al-Mahdi University, Isfahan, IR Iran Al-Mahdi University, Isfahan, IR Iran Akbar Hassanzade Akbar Hassanzade Department of Epidemiology and Biostatistics, School of Health, Isfahan University of Medical Sciences, Isfahan, IR Iran Department of Epidemiology and Biostatistics, School of Health, Isfahan University of Medical Sciences, Isfahan, IR Iran Soghra Sheikhzadeh Soghra Sheikhzadeh NICU Ward, Al-Zahra Hospital, Isfahan University of Medical Sciences, Isfahan, IR Iran NICU Ward, Al-Zahra Hospital, Isfahan University of Medical Sciences, Isfahan, IR Iran Maryam Sharif Tehrani Maryam Sharif Tehrani NICU Ward, Al-Zahra Hospital, Isfahan University of Medical Sciences, Isfahan, IR Iran NICU Ward, Al-Zahra Hospital, Isfahan University of Medical Sciences, Isfahan, IR Iran Gohar Rezvan Gohar Rezvan NICU Ward, Al-Zahra Hospital, Isfahan University of Medical Sciences, Isfahan, IR Iran NICU Ward, Al-Zahra Hospital, Isfahan University of Medical Sciences, Isfahan, IR Iran
en 25389473 10.5812/ircmj.13079 Comparison of Ondansetron and Meperidine for Treatment of Postoperative Shivering: A Randomized Controlled Clinical Trial Comparison of Ondansetron and Meperidine for Treatment of Postoperative Shivering: A Randomized Controlled Clinical Trial research-article research-article Background

The involved neurotransmitter pathways in the postoperative shivering (POS) are poorly understood. Recently, 5-hydroxytryptamine 3 (5-HT3) receptor antagonists have been reported to prevent POS. We investigated the effect of ondansetron, a 5-HT3 antagonist that is used to treat postoperative nausea and vomiting, on shivering.

Objectives

This study aimed to compare the efficacy of ondansetron and meperidine in the treatment of shivering after general anesthesia.

Patients and Methods

In this double-blinded randomized clinical trial, 83 patients (age range, 18-60 years) who had shivering after general anesthesia were randomly allocated to any of these three groups: Group A, (number = 27) received 4 mg of intravenous ondansetron, Group B, (number = 27) received 8 mg of intravenous ondansetron, and Group C, (number = 29) received 0.4 mg/kg of intravenous meperidine at recovery room. The surface temperatures and the incidence as well as intensity of shivering were recorded.

Results

Shivering was controlled in 16 patients (59%) in Group A, 22 (81%) in Group B, and 25 (86%) in Group C (P = 0.01). Within each group, there were no significant differences among the surface temperature in recovery room. Patients in groups A and B had significantly lower incidence of nausea and vomiting than group C (P = 0.01).

Conclusions

Ondansetron and meperidine have similar effects on shivering. We concluded that 8 mg of intravenous ondansetron can control shivering and this is the dose of choice, especially in patients with POS with nausea and vomiting.

Background

The involved neurotransmitter pathways in the postoperative shivering (POS) are poorly understood. Recently, 5-hydroxytryptamine 3 (5-HT3) receptor antagonists have been reported to prevent POS. We investigated the effect of ondansetron, a 5-HT3 antagonist that is used to treat postoperative nausea and vomiting, on shivering.

Objectives

This study aimed to compare the efficacy of ondansetron and meperidine in the treatment of shivering after general anesthesia.

Patients and Methods

In this double-blinded randomized clinical trial, 83 patients (age range, 18-60 years) who had shivering after general anesthesia were randomly allocated to any of these three groups: Group A, (number = 27) received 4 mg of intravenous ondansetron, Group B, (number = 27) received 8 mg of intravenous ondansetron, and Group C, (number = 29) received 0.4 mg/kg of intravenous meperidine at recovery room. The surface temperatures and the incidence as well as intensity of shivering were recorded.

Results

Shivering was controlled in 16 patients (59%) in Group A, 22 (81%) in Group B, and 25 (86%) in Group C (P = 0.01). Within each group, there were no significant differences among the surface temperature in recovery room. Patients in groups A and B had significantly lower incidence of nausea and vomiting than group C (P = 0.01).

Conclusions

Ondansetron and meperidine have similar effects on shivering. We concluded that 8 mg of intravenous ondansetron can control shivering and this is the dose of choice, especially in patients with POS with nausea and vomiting.

Anesthetics;Adverse Effects;Meperidine;Therapeutics;Ondansetron;Shivering Anesthetics;Adverse Effects;Meperidine;Therapeutics;Ondansetron;Shivering http://www.ircmj.com/index.php?page=article&article_id=13079 Alireza Mahoori Alireza Mahoori Department of Anesthesiology, Imam Khomeini Training Hospital, Urmia University of Medical Sciences, Urmia, IR Iran Department of Anesthesiology, Imam Khomeini Training Hospital, Urmia University of Medical Sciences, Urmia, IR Iran Heydar Noroozinia Heydar Noroozinia Department of Anesthesiology, Imam Khomeini Training Hospital, Urmia University of Medical Sciences, Urmia, IR Iran; Department of Anesthesiology, Imam Khomeini Training Hospital, Urmia University of Medical Sciences, Urmia, IR Iran. Tel: +98-4413468967; +98-9143416531, Fax: +98-4413468967 Department of Anesthesiology, Imam Khomeini Training Hospital, Urmia University of Medical Sciences, Urmia, IR Iran; Department of Anesthesiology, Imam Khomeini Training Hospital, Urmia University of Medical Sciences, Urmia, IR Iran. Tel: +98-4413468967; +98-9143416531, Fax: +98-4413468967 Ebrahim Hasani Ebrahim Hasani Department of Anesthesiology, Imam Khomeini Training Hospital, Urmia University of Medical Sciences, Urmia, IR Iran Department of Anesthesiology, Imam Khomeini Training Hospital, Urmia University of Medical Sciences, Urmia, IR Iran Maryam Soltanahmadi Maryam Soltanahmadi Department of Anesthesiology, Imam Khomeini Training Hospital, Urmia University of Medical Sciences, Urmia, IR Iran Department of Anesthesiology, Imam Khomeini Training Hospital, Urmia University of Medical Sciences, Urmia, IR Iran
en 25389496 10.5812/ircmj.6915 Effects of Simvastatin Treatment on Serum Adiponectin Concentrations in Patients With Dislipidemia Effects of Simvastatin Treatment on Serum Adiponectin Concentrations in Patients With Dislipidemia research-article research-article Background

Adiponectin is an adipose tissue-derived protein with anti-inflammatory properties. Statins are a class of cholesterol-lowering drugs, widely used for treatment of cardiovascular diseases.

Objectives

In the current study, we aimed to assess the effects of simvastatin on serum levels of adiponectin in patients with dyslipidemia, recruited from Ghaem Hospital, Mashhad, Iran.

Materials and Methods

A total of 102 patients with dyslipidemia were treated with simvastatin or placebo during a double-blind, cross-over, placebo-controlled trial. The adiponectin levels were measured before and after each treatment period. Seventy seven participants completed the study.

Results

There was a significant reduction in serum total cholesterol (approxmately 21%), low density lipoprotein-cholesterol (LDL-C) (approxmately 28%), and triglycerides (approxmately 11%), after four weeks of treatment with simvastatin (P < 0.001).

Conclusions

No significant change in serum adiponectin concentrations was observed after treatment with simvastatin. This may be because of the relatively short duration of treatment and longer treatment duration may be necessary to investigation in future studies.

Background

Adiponectin is an adipose tissue-derived protein with anti-inflammatory properties. Statins are a class of cholesterol-lowering drugs, widely used for treatment of cardiovascular diseases.

Objectives

In the current study, we aimed to assess the effects of simvastatin on serum levels of adiponectin in patients with dyslipidemia, recruited from Ghaem Hospital, Mashhad, Iran.

Materials and Methods

A total of 102 patients with dyslipidemia were treated with simvastatin or placebo during a double-blind, cross-over, placebo-controlled trial. The adiponectin levels were measured before and after each treatment period. Seventy seven participants completed the study.

Results

There was a significant reduction in serum total cholesterol (approxmately 21%), low density lipoprotein-cholesterol (LDL-C) (approxmately 28%), and triglycerides (approxmately 11%), after four weeks of treatment with simvastatin (P < 0.001).

Conclusions

No significant change in serum adiponectin concentrations was observed after treatment with simvastatin. This may be because of the relatively short duration of treatment and longer treatment duration may be necessary to investigation in future studies.

Atherosclerosis;Adiponectin;Statins Atherosclerosis;Adiponectin;Statins http://www.ircmj.com/index.php?page=article&article_id=6915 Atefeh Moezzi Atefeh Moezzi Biochemistry of Nutrition Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran Biochemistry of Nutrition Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran Seyyed Mohammad Reza Parizadeh Seyyed Mohammad Reza Parizadeh Cardiovascular Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran Cardiovascular Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran Shima Tavallaie Shima Tavallaie Biochemistry of Nutrition Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran Biochemistry of Nutrition Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran Mohsen Mazidi Mohsen Mazidi Biochemistry of Nutrition Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran Biochemistry of Nutrition Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran Fariba Afzali Fariba Afzali Biochemistry of Nutrition Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran Biochemistry of Nutrition Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran Afrouz Adab Afrouz Adab Biochemistry of Nutrition Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran Biochemistry of Nutrition Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran Gordon Ferns Gordon Ferns Brighton and Sussex Medical School, University of Sussex, Brighton, United Kingdom Brighton and Sussex Medical School, University of Sussex, Brighton, United Kingdom Majid Ghayour Mobarhan Majid Ghayour Mobarhan Biochemistry of Nutrition Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran; Cardiovascular Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran; , Cardiovascular Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran. Tel: +98-5118829261, Fax: +98-5118827040 Biochemistry of Nutrition Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran; Cardiovascular Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran; , Cardiovascular Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran. Tel: +98-5118829261, Fax: +98-5118827040
en 25389470 10.5812/ircmj.11856 Disclosure of HIV Status and Social Support Among People Living With HIV Disclosure of HIV Status and Social Support Among People Living With HIV research-article research-article Background

Disclosure of HIV is important for improving self-care behaviors, psychological well-being, commitment to the treatment, and reducing risk of transmission. One of the major benefits of disclosure is social support, which is an essential resource for effective coping with HIV infection. However, receiving any social support requires disclosing of HIV status.

Objectives

This study aimed to determine the disclosure of HIV status and its related factors such as social support in addition to demographic and disease characteristics among people living with HIV in Iran.

Patients and Methods

This cross-sectional study, using simple random sampling, was carried out on 175 people with HIV/AIDS who referred to Behavioral Counseling Centers. The self-administrated, Norbeck Social Support Questionnaire was used to measure social support. Disclosure of HIV status was assessed with an investigator-designed questions. Multiple logistic regression analysis with backward Likelihood Ratio method was applied to identify the adjusted odds ratio between disclosure as dependent variable and demographic variables, social support as independent variables.

Results

Participants were often disclosed their HIV status to family members. But there were differences about disclosure of HIV status within the context of the family. Family members were perceived as more supportive. Multiple logistic regression analysis demonstrates that the gender (adjusted OR = 0.181; 95% CI .068-0.479), CD4 cell count (adjusted OR = 0.997; 95% CI 0.994-0.999), route of transmission (injection-drug user [adjusted OR = 9.366; 95% CI 3.358-26.123] and other routes [tattooing, mother to child, dental services, etc.], [adjusted OR = 3.752; 95% CI 1.157-12.167]), and functional support variable (adjusted OR = 1.007; 95% CI 1.001-1.013) remained in the model as significant predictors for disclosure.

Conclusions

The results of this study regarding disclosure of HIV status and its relations to social support and some demographic variables can provide an understanding based on the evidence for promotion of knowledge and coping interventions about people living with HIV/AIDS and their perceived social support status.

Background

Disclosure of HIV is important for improving self-care behaviors, psychological well-being, commitment to the treatment, and reducing risk of transmission. One of the major benefits of disclosure is social support, which is an essential resource for effective coping with HIV infection. However, receiving any social support requires disclosing of HIV status.

Objectives

This study aimed to determine the disclosure of HIV status and its related factors such as social support in addition to demographic and disease characteristics among people living with HIV in Iran.

Patients and Methods

This cross-sectional study, using simple random sampling, was carried out on 175 people with HIV/AIDS who referred to Behavioral Counseling Centers. The self-administrated, Norbeck Social Support Questionnaire was used to measure social support. Disclosure of HIV status was assessed with an investigator-designed questions. Multiple logistic regression analysis with backward Likelihood Ratio method was applied to identify the adjusted odds ratio between disclosure as dependent variable and demographic variables, social support as independent variables.

Results

Participants were often disclosed their HIV status to family members. But there were differences about disclosure of HIV status within the context of the family. Family members were perceived as more supportive. Multiple logistic regression analysis demonstrates that the gender (adjusted OR = 0.181; 95% CI .068-0.479), CD4 cell count (adjusted OR = 0.997; 95% CI 0.994-0.999), route of transmission (injection-drug user [adjusted OR = 9.366; 95% CI 3.358-26.123] and other routes [tattooing, mother to child, dental services, etc.], [adjusted OR = 3.752; 95% CI 1.157-12.167]), and functional support variable (adjusted OR = 1.007; 95% CI 1.001-1.013) remained in the model as significant predictors for disclosure.

Conclusions

The results of this study regarding disclosure of HIV status and its relations to social support and some demographic variables can provide an understanding based on the evidence for promotion of knowledge and coping interventions about people living with HIV/AIDS and their perceived social support status.

Disclosure;HIV;Social Support;Iran Disclosure;HIV;Social Support;Iran http://www.ircmj.com/index.php?page=article&article_id=11856 Zahra Jorjoran Shushtari Zahra Jorjoran Shushtari Health Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, IR Iran Health Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, IR Iran Homeira Sajjadi Homeira Sajjadi Social Determinants of Health Research Center, Department of Social Welfare Management, University of Social Welfare and Rehabilitation Sciences, Tehran, IR Iran; Social Determinants of Health Research Center, Department of Social Welfare Management, University of Social Welfare and Rehabilitation Sciences, Tehran, IR Iran. Tel: +98-2144235998 Social Determinants of Health Research Center, Department of Social Welfare Management, University of Social Welfare and Rehabilitation Sciences, Tehran, IR Iran; Social Determinants of Health Research Center, Department of Social Welfare Management, University of Social Welfare and Rehabilitation Sciences, Tehran, IR Iran. Tel: +98-2144235998 Ameneh Setareh Forouzan Ameneh Setareh Forouzan Social Determinants of Health Research Center, Department of Social Welfare Management, University of Social Welfare and Rehabilitation Sciences, Tehran, IR Iran Social Determinants of Health Research Center, Department of Social Welfare Management, University of Social Welfare and Rehabilitation Sciences, Tehran, IR Iran Yahya Salimi Yahya Salimi Department of Epidemiology and Biostatistics, Public Health School, Kermanshah University of Medical Sciences, Kermanshah, IR Iran; Department of Epidemiology and Biostatistics, Public Health School, Tehran University of Medical Sciences, Tehran, IR Iran Department of Epidemiology and Biostatistics, Public Health School, Kermanshah University of Medical Sciences, Kermanshah, IR Iran; Department of Epidemiology and Biostatistics, Public Health School, Tehran University of Medical Sciences, Tehran, IR Iran Masoumeh Dejman Masoumeh Dejman Social Determinants of Health Research Center, Department of Social Welfare Management, University of Social Welfare and Rehabilitation Sciences, Tehran, IR Iran Social Determinants of Health Research Center, Department of Social Welfare Management, University of Social Welfare and Rehabilitation Sciences, Tehran, IR Iran
en 25389477 10.5812/ircmj.13592 Comparison of Topical Nifedipine With Oral Nifedipine for Treatment of Anal Fissure: A Randomized Controlled Trial Comparison of Topical Nifedipine With Oral Nifedipine for Treatment of Anal Fissure: A Randomized Controlled Trial research-article research-article Background

Medical sphincterotomy has gained popularity as a treatment for anal fissure. Calcium channel blockers in topical forms could also be appropriate with low adverse effects.

Objectives

This was a prospective randomized controlled trial to compare topical and oral nifedipine in the treatment of chronic anal fissure.

Patients and Methods

A prospective randomized controlled trial was conducted at two centers of Shahed University. One hundred and thirty patients with chronic anal fissure aged 18 to 60 years managed in our clinics were included in this study. The patients were randomly divided into two groups. Sixty-five patients received topical nifedipine (TN) and the same number received oral nifedipine (ON).

Results

Ulcer healing occurred in 43 (73.33%) of topical nifedipine group compared to 29 (49.5%) patients in oral nifedipine, which was significantly different (P < 0.05). Side effects such as headache and flushing in oral nifedipine group were more prevalent than topical nifedipine, which was statistically different. Recurrence rates were the same after six months of follow-up.

Conclusions

Although oral nifedipine can reduce symptom and signs of anal fissure, topical nifedipine has a superior role for anal fissure treatment with higher healing rate and lower side effects.

Background

Medical sphincterotomy has gained popularity as a treatment for anal fissure. Calcium channel blockers in topical forms could also be appropriate with low adverse effects.

Objectives

This was a prospective randomized controlled trial to compare topical and oral nifedipine in the treatment of chronic anal fissure.

Patients and Methods

A prospective randomized controlled trial was conducted at two centers of Shahed University. One hundred and thirty patients with chronic anal fissure aged 18 to 60 years managed in our clinics were included in this study. The patients were randomly divided into two groups. Sixty-five patients received topical nifedipine (TN) and the same number received oral nifedipine (ON).

Results

Ulcer healing occurred in 43 (73.33%) of topical nifedipine group compared to 29 (49.5%) patients in oral nifedipine, which was significantly different (P < 0.05). Side effects such as headache and flushing in oral nifedipine group were more prevalent than topical nifedipine, which was statistically different. Recurrence rates were the same after six months of follow-up.

Conclusions

Although oral nifedipine can reduce symptom and signs of anal fissure, topical nifedipine has a superior role for anal fissure treatment with higher healing rate and lower side effects.

Fissure in Ano;Nifedipine;Sphincterotomy, Endoscopic Fissure in Ano;Nifedipine;Sphincterotomy, Endoscopic http://www.ircmj.com/index.php?page=article&article_id=13592 Farzaneh Golfam Farzaneh Golfam Department of Surgery, Mostafa Khomeini Hospital, Shahed University, Tehran, IR Iran Department of Surgery, Mostafa Khomeini Hospital, Shahed University, Tehran, IR Iran Parisa Golfam Parisa Golfam Department of Anesthesiology, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, IR Iran; Department of Anesthesiology, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, IR Iran. Tel: +98-9181310864, Fax: +98-8317246693 Department of Anesthesiology, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, IR Iran; Department of Anesthesiology, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, IR Iran. Tel: +98-9181310864, Fax: +98-8317246693 Babak Golfam Babak Golfam Department of Anesthesiology, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Department of Anesthesiology, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Puyan Pahlevani Puyan Pahlevani Hamadan University of Medical Sciences, Hamadan, IR Iran Hamadan University of Medical Sciences, Hamadan, IR Iran
en 25389474 10.5812/ircmj.13088 The Assessment of Undergraduate Medical Students’ Satisfaction Levels With the Objective Structured Clinical Examination The Assessment of Undergraduate Medical Students’ Satisfaction Levels With the Objective Structured Clinical Examination research-article research-article Background

The objective structured clinical examination (OSCE) has been introduced as an efficient method for the assessment of medical students.

Objectives

The aim of the present study was to determine the satisfaction level of undergraduate medical students of internal medicine department with the OSCE.

Materials and Methods

This was a descriptive cross-sectional study, performed on all available undergraduate students at the end of their internal medicine training period in Mashhad University of Medical Sciences. The students responded to 15 multiple-choice questions with confirmed validity and reliability.

Results

The majority of the students (94.5%) had a positive attitude toward the OSCE and mentioned that the OSCE format was a more appropriate type of exam than other methods of testing; however, 79.1% thought that the OSCE format was stressful. In addition, the participants’ sex had no effect on their level of satisfaction with the examination. Likewise, there was no significant correlation between their level of satisfaction and their age, marital status, or lack of previous experience with this type of exam.

Conclusions

If the exam standards are met and a uniform dispersion of the scientific content is maintained, the OSCE method of assessment can be recommended as an efficient and applicable method for assessing medical students.

Background

The objective structured clinical examination (OSCE) has been introduced as an efficient method for the assessment of medical students.

Objectives

The aim of the present study was to determine the satisfaction level of undergraduate medical students of internal medicine department with the OSCE.

Materials and Methods

This was a descriptive cross-sectional study, performed on all available undergraduate students at the end of their internal medicine training period in Mashhad University of Medical Sciences. The students responded to 15 multiple-choice questions with confirmed validity and reliability.

Results

The majority of the students (94.5%) had a positive attitude toward the OSCE and mentioned that the OSCE format was a more appropriate type of exam than other methods of testing; however, 79.1% thought that the OSCE format was stressful. In addition, the participants’ sex had no effect on their level of satisfaction with the examination. Likewise, there was no significant correlation between their level of satisfaction and their age, marital status, or lack of previous experience with this type of exam.

Conclusions

If the exam standards are met and a uniform dispersion of the scientific content is maintained, the OSCE method of assessment can be recommended as an efficient and applicable method for assessing medical students.

Undergraduate;Medical Students;Internal Medicine;Personal Satisfaction Undergraduate;Medical Students;Internal Medicine;Personal Satisfaction http://www.ircmj.com/index.php?page=article&article_id=13088 Ahmad Khosravi Khorashad Ahmad Khosravi Khorashad Department of Internal Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran Department of Internal Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran Somayyeh Salari Somayyeh Salari Department of Internal Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran Department of Internal Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran Humain Baharvahdat Humain Baharvahdat Department of Neurosurgery, Mashhad University of Medical Sciences, Mashhad, IR Iran Department of Neurosurgery, Mashhad University of Medical Sciences, Mashhad, IR Iran Sepideh Hejazi Sepideh Hejazi Department of Internal Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran Department of Internal Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran Shiva M Lari Shiva M Lari Health Care Administration, California State University of Northridge, Northridge, USA Health Care Administration, California State University of Northridge, Northridge, USA Maasoomeh Salari Maasoomeh Salari Department of Internal Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran Department of Internal Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran Maryam Mazloomi Maryam Mazloomi COPD Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran COPD Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran Shahrzad M Lari Shahrzad M Lari COPD Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran; COPD Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran. Tel: +98-5118452146/+98-9151105824 COPD Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran; COPD Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran. Tel: +98-5118452146/+98-9151105824
en 25389475 10.5812/ircmj.13533 Association of MEF2A Gene Polymorphisms With Coronary Artery Disease Association of <italic>MEF2A </italic>Gene Polymorphisms With Coronary Artery Disease research-article research-article Background

Coronary Artery Disease (CAD) is the most common cause of death worldwide. MEF2A directly regulates target genes in the process of muscle development. This gene product is a transcription factor. MEF2A protein in homodimer or heterodimer forms binds to A/T-rich cis elements with conserved sequence in promoter, regulator, and enhancer of many genes, which are determining in evolution and development of skeletal, heart, and smooth muscle cells, especially endothelial cells. In fact, this protein maximizes the activity of these elements.

Objectives

The two MEF2A gene polymorphisms that were proposed to have an association with CAD are rs34851361 (A/G) and rs325400 (T/G) SNPs. This study aimed to examine these associations.

Patients and Methods

This study was a molecular case-control study. Blood samples were collected from 300 patients with CAD and 150 healthy people from Golestan and Imam Khomeini Hospitals, Ahvaz, Iran. In both groups, angiography had confirmed the presence or lack of stenosis. Association of rs34851361 and rs325400 with CAD was evaluated by PCR and then restriction fragment length polymorphism (RFLP) analysis was performed.

Results

Chi square test showed no association between rs34851361 SNP and CAD (χ2 = 3.59, df = 2, and P = 0.16); however, there was an association between rs325400 SNP and CAD (χ2 = 24.77, df = 2, and P < 0.001). A/T haplotype showed association with CAD and G/G and G/T showed protective effect against CAD.

Conclusions

The results of this study show that rs325400 polymorphism is in association with CAD; meanwhile, none of the rs34851361 genotypes was associated with CAD.

Background

Coronary Artery Disease (CAD) is the most common cause of death worldwide. MEF2A directly regulates target genes in the process of muscle development. This gene product is a transcription factor. MEF2A protein in homodimer or heterodimer forms binds to A/T-rich cis elements with conserved sequence in promoter, regulator, and enhancer of many genes, which are determining in evolution and development of skeletal, heart, and smooth muscle cells, especially endothelial cells. In fact, this protein maximizes the activity of these elements.

Objectives

The two MEF2A gene polymorphisms that were proposed to have an association with CAD are rs34851361 (A/G) and rs325400 (T/G) SNPs. This study aimed to examine these associations.

Patients and Methods

This study was a molecular case-control study. Blood samples were collected from 300 patients with CAD and 150 healthy people from Golestan and Imam Khomeini Hospitals, Ahvaz, Iran. In both groups, angiography had confirmed the presence or lack of stenosis. Association of rs34851361 and rs325400 with CAD was evaluated by PCR and then restriction fragment length polymorphism (RFLP) analysis was performed.

Results

Chi square test showed no association between rs34851361 SNP and CAD (χ2 = 3.59, df = 2, and P = 0.16); however, there was an association between rs325400 SNP and CAD (χ2 = 24.77, df = 2, and P < 0.001). A/T haplotype showed association with CAD and G/G and G/T showed protective effect against CAD.

Conclusions

The results of this study show that rs325400 polymorphism is in association with CAD; meanwhile, none of the rs34851361 genotypes was associated with CAD.

Coronary Artery Disease;Polymorphism, Single Nucleotide;Polymorphism, Restriction Fragment Length Coronary Artery Disease;Polymorphism, Single Nucleotide;Polymorphism, Restriction Fragment Length http://www.ircmj.com/index.php?page=article&article_id=13533 Ali Mohammad Foroughmand Ali Mohammad Foroughmand Faculty of Science, Department of Genetics, Shahid Chamran University of Ahvaz, Ahvaz, IR Iran Faculty of Science, Department of Genetics, Shahid Chamran University of Ahvaz, Ahvaz, IR Iran Zahra Shahbazi Zahra Shahbazi Faculty of Science, Department of Genetics, Shahid Chamran University of Ahvaz, Ahvaz, IR Iran; Faculty of Science, Department of Genetics, Shahid Chamran University of Ahvaz, Ahvaz, IR Iran. Tel: +98-9380889172 Faculty of Science, Department of Genetics, Shahid Chamran University of Ahvaz, Ahvaz, IR Iran; Faculty of Science, Department of Genetics, Shahid Chamran University of Ahvaz, Ahvaz, IR Iran. Tel: +98-9380889172 Hamid Galehdari Hamid Galehdari Faculty of Science, Department of Genetics, Shahid Chamran University of Ahvaz, Ahvaz, IR Iran Faculty of Science, Department of Genetics, Shahid Chamran University of Ahvaz, Ahvaz, IR Iran Mahdi Purmahdi Borujeni Mahdi Purmahdi Borujeni Faculty of Veterinary Medicine, Department of Food Hygiene, Shahid Chamran University of Ahvaz, Ahvaz, IR Iran Faculty of Veterinary Medicine, Department of Food Hygiene, Shahid Chamran University of Ahvaz, Ahvaz, IR Iran Parvane Dinarvand Parvane Dinarvand Faculty of Science, Department of Genetics, Shahid Chamran University of Ahvaz, Ahvaz, IR Iran Faculty of Science, Department of Genetics, Shahid Chamran University of Ahvaz, Ahvaz, IR Iran Khadije Golabgirkhademi Khadije Golabgirkhademi Faculty of Science, Department of Genetics, Shahid Chamran University of Ahvaz, Ahvaz, IR Iran Faculty of Science, Department of Genetics, Shahid Chamran University of Ahvaz, Ahvaz, IR Iran
en 25389479 10.5812/ircmj.14122 Thin Cord Syndrome in a Thirty-year-old Pregnant Woman Thin Cord Syndrome in a Thirty-year-old Pregnant Woman case-report case-report Introduction

The umbilical cord anomalies directly effect on the life quality of the fetus. It can lead to fetal death or many problems during pregnancy and delivery. Early detection of these abnormalities is of particular importance.

Case Presentation

We report a case of thin cord syndrome (TCS) in a 30-year-old pregnant woman with suprapubic pain. After termination of pregnancy, histopathologic assessment confirmed the TCS.

Conclusions

In all cases with suspected abortion, the umbilical cord disorder should be considered.

Introduction

The umbilical cord anomalies directly effect on the life quality of the fetus. It can lead to fetal death or many problems during pregnancy and delivery. Early detection of these abnormalities is of particular importance.

Case Presentation

We report a case of thin cord syndrome (TCS) in a 30-year-old pregnant woman with suprapubic pain. After termination of pregnancy, histopathologic assessment confirmed the TCS.

Conclusions

In all cases with suspected abortion, the umbilical cord disorder should be considered.

Umbilical Cord; Cord Syndrome; Abnormalities Umbilical Cord; Cord Syndrome; Abnormalities http://www.ircmj.com/index.php?page=article&article_id=14122 Mohammadreza Hafeziahmadi Mohammadreza Hafeziahmadi Department of Pathology, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, IR Iran Department of Pathology, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, IR Iran Atefeh Yousefi Atefeh Yousefi Student Research Committee, Ilam University of Medical Sciences, Ilam, IR Iran Student Research Committee, Ilam University of Medical Sciences, Ilam, IR Iran Samiramis Ghavam Samiramis Ghavam Department of Cardiology, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, IR Iran Department of Cardiology, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, IR Iran Sajjad Alizadeh Sajjad Alizadeh Student Research Committee, Ilam University of Medical Sciences, Ilam, IR Iran; Student Research Committee, Ilam University of Medical Sciences, Ilam, IR Iran. Tel: +98-9187467005, Fax: +98-8412227136 Student Research Committee, Ilam University of Medical Sciences, Ilam, IR Iran; Student Research Committee, Ilam University of Medical Sciences, Ilam, IR Iran. Tel: +98-9187467005, Fax: +98-8412227136
en 25389469 10.5812/ircmj.11747 Occupational Stress and Cardiovascular Risk Factors in High-Ranking Government Officials and Office Workers Occupational Stress and Cardiovascular Risk Factors in High-Ranking Government Officials and Office Workers research-article research-article Results

High-ranking officials in our study had less work experience in their current jobs and smoked fewer pack-years of cigarette, but they had higher waist and hip circumference, higher triglyceride level, more stress from role overload and responsibility, and higher total stress score. Our group of office workers had more occupational stress because of role ambiguity and insufficiency, but their overall job stress was less than officials.

Patients and Methods

We invited 90 high-ranking officials who managed the main governmental offices in a city, and 90 age and sex-matched office workers. The subjects were required to fill the occupational role questionnaire (Osipow) which evaluated their personal and medical history as well as occupational stress. Then, we performed physical examination and laboratory tests to check for cardiovascular risk factors. Finally, the frequency of cardiovascular risk factors and occupational stress of two groups were compared.

Background

Cardiovascular diseases are among the most important sources of mortality and morbidity, and have a high disease burden. There are some major well-known risk factors, which contribute to the development of these diseases. Occupational stress is caused due to imbalance between job demands and individual’s ability, and it has been implicated as an etiology for cardiovascular diseases.

Objectives

This study was conducted to evaluate the cardiovascular risk factors and different dimensions of occupational stress in high-ranking government officials, comparing an age and sex-matched group of office workers with them.

Conclusions

The officials have higher scores in some dimensions of occupational stress and higher overall stress score. Some cardiovascular risk factors were also more frequent in managers.

Results

High-ranking officials in our study had less work experience in their current jobs and smoked fewer pack-years of cigarette, but they had higher waist and hip circumference, higher triglyceride level, more stress from role overload and responsibility, and higher total stress score. Our group of office workers had more occupational stress because of role ambiguity and insufficiency, but their overall job stress was less than officials.

Patients and Methods

We invited 90 high-ranking officials who managed the main governmental offices in a city, and 90 age and sex-matched office workers. The subjects were required to fill the occupational role questionnaire (Osipow) which evaluated their personal and medical history as well as occupational stress. Then, we performed physical examination and laboratory tests to check for cardiovascular risk factors. Finally, the frequency of cardiovascular risk factors and occupational stress of two groups were compared.

Background

Cardiovascular diseases are among the most important sources of mortality and morbidity, and have a high disease burden. There are some major well-known risk factors, which contribute to the development of these diseases. Occupational stress is caused due to imbalance between job demands and individual’s ability, and it has been implicated as an etiology for cardiovascular diseases.

Objectives

This study was conducted to evaluate the cardiovascular risk factors and different dimensions of occupational stress in high-ranking government officials, comparing an age and sex-matched group of office workers with them.

Conclusions

The officials have higher scores in some dimensions of occupational stress and higher overall stress score. Some cardiovascular risk factors were also more frequent in managers.

Cardiovascular Risk Factor;Burnout, Professional;Managers Cardiovascular Risk Factor;Burnout, Professional;Managers http://www.ircmj.com/index.php?page=article&article_id=11747 Seyyed Jalil Mirmohammadi Seyyed Jalil Mirmohammadi Department of Occupational Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, IR Iran Department of Occupational Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, IR Iran Mahmoud Taheri Mahmoud Taheri Department of Occupational Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, IR Iran; Department of Occupational Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, IR Iran. Tel: +98-3516229193, Fax: +98-3516229194 Department of Occupational Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, IR Iran; Department of Occupational Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, IR Iran. Tel: +98-3516229193, Fax: +98-3516229194 Amir Houshang Mehrparvar Amir Houshang Mehrparvar Department of Occupational Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, IR Iran Department of Occupational Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, IR Iran Mohammad Heydari Mohammad Heydari Department of Occupational Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, IR Iran Department of Occupational Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, IR Iran Ali Saadati Kanafi Ali Saadati Kanafi Department of Surgery, Tehran University of Medical Sciences, Tehran, IR Iran Department of Surgery, Tehran University of Medical Sciences, Tehran, IR Iran Mehrdad Mostaghaci Mehrdad Mostaghaci Department of Occupational Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, IR Iran Department of Occupational Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, IR Iran
en 25389485 10.5812/ircmj.18346 Behavioral Prevention Regarding Sexually Transmitted Infections and its Predictors in Women Behavioral Prevention Regarding Sexually Transmitted Infections and its Predictors in Women research-article research-article Background

Sexually transmitted infections (STIs) have a major negative impact on sexual and reproductive health globally. The most effective way to avoid STIs is to abstain from sexual contact or having sex only in a long-term, mutually monogamous relationship with an uninfected partner.

Objectives

This study aimed to determine behavioral prevention regarding STIs.

Patients and Methods

This analytic cross-sectional study was performed on 584 women aged 15-49 referring to health care centers of Tabriz-Iran in 2013 through multistage cluster sampling. Data collecting tool was a questionnaire which its validity and reliability were determined previously. Descriptive and inferential statistics (independent T-test, One-way ANOVA, and univariate and multivariate analyses) were used to analyze the data using SPSS 17. P < 0.05 was considered significant.

Results

The mean ± SD score of behavioral prevention was 20.57 ± 2.8 ranging from 0 to 24. The weakest behavioral prevention was lack of consistent use of condom by husband during sex. The mean ± SD score of individuals’ awareness about STIs was as low as 17.08 ± 7.42. Multivariate analysis adjusting potential confounders showed a significant association between behavioral prevention and awareness, education, sex only with husband, anal, oral, and anal-oral sex.

Conclusions

Prevention and care of sexually transmitted diseases are interventions able to promote public health. It is necessary to solve different factors affecting rapid spread of STDs and their transmission through an effective behavioral preventive plan.

Background

Sexually transmitted infections (STIs) have a major negative impact on sexual and reproductive health globally. The most effective way to avoid STIs is to abstain from sexual contact or having sex only in a long-term, mutually monogamous relationship with an uninfected partner.

Objectives

This study aimed to determine behavioral prevention regarding STIs.

Patients and Methods

This analytic cross-sectional study was performed on 584 women aged 15-49 referring to health care centers of Tabriz-Iran in 2013 through multistage cluster sampling. Data collecting tool was a questionnaire which its validity and reliability were determined previously. Descriptive and inferential statistics (independent T-test, One-way ANOVA, and univariate and multivariate analyses) were used to analyze the data using SPSS 17. P < 0.05 was considered significant.

Results

The mean ± SD score of behavioral prevention was 20.57 ± 2.8 ranging from 0 to 24. The weakest behavioral prevention was lack of consistent use of condom by husband during sex. The mean ± SD score of individuals’ awareness about STIs was as low as 17.08 ± 7.42. Multivariate analysis adjusting potential confounders showed a significant association between behavioral prevention and awareness, education, sex only with husband, anal, oral, and anal-oral sex.

Conclusions

Prevention and care of sexually transmitted diseases are interventions able to promote public health. It is necessary to solve different factors affecting rapid spread of STDs and their transmission through an effective behavioral preventive plan.

Behavior;Prevention;Oral Sex;Infections;Women;Iran Behavior;Prevention;Oral Sex;Infections;Women;Iran http://www.ircmj.com/index.php?page=article&article_id=18346 Azizeh Farshbaf-khalili Azizeh Farshbaf-khalili Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, IR Iran; Research Center of National Public Health Management (NPMC), Tabriz University of Medical Sciences, Tabriz, IR Iran Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, IR Iran; Research Center of National Public Health Management (NPMC), Tabriz University of Medical Sciences, Tabriz, IR Iran Mahnaz Shahnazi Mahnaz Shahnazi Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, IR Iran Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, IR Iran Hanieh Salehi-pourmehr Hanieh Salehi-pourmehr Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, IR Iran; Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, IR Iran. Tel: +98-4114796770, Fax: +98-4114796969 Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, IR Iran; Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, IR Iran. Tel: +98-4114796770, Fax: +98-4114796969 Fatemeh Faridvand Fatemeh Faridvand Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, IR Iran Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, IR Iran Zoleikha Asgarloo Zoleikha Asgarloo Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, IR Iran Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, IR Iran
en 25389476 10.5812/ircmj.13579 Low Frequency Repetitive Transcranial Magnetic Stimulation to Improve Motor Function and Grip Force of Upper Limbs of Patients With Hemiplegia Low Frequency Repetitive Transcranial Magnetic Stimulation to Improve Motor Function and Grip Force of Upper Limbs of Patients With Hemiplegia research-article research-article Results

In the control group, Barthel and Fugl-Meyer indices showed significant improvement (P = 0.01, P = 0.00), while in the experimental group, significant improvement in Barthel and Fugl-Meyer indices and dynamometers has been observed (P = 0.01, P = 0.00, P = 0.007).

Conclusions

rTMS can improve hand muscle force and functions of patients with chronic hemiplegia, while conventional treatment is not effective.

Patients and Methods

In this study, 12 patients with hemiplegia were randomly divided in two groups. Control group, received the rehabilitation program with placebo magnetic stimulation, and the experimental group, received magnetic stimulation with routine rehabilitation program for 10 sessions for three times per week. Pre and post evaluations of treatment performed using Barthel and Fugl-Meyer indices and dynamometers.

Background

Stroke is the most common and debilitating neurological disorder among adults, and is a sudden onset of neurological signs caused by brain blood vessels impairments.

Objectives

Some new therapeutic methods focus on the use of magnetic stimulation to produce therapeutic effects by inducing the currents. The aim of this study is to determine the effects of rTMS plus routine rehabilitation on hand grip and wrist motor functions in patients with hemiplegia, and compare with pure routine rehabilitation programs.

Results

In the control group, Barthel and Fugl-Meyer indices showed significant improvement (P = 0.01, P = 0.00), while in the experimental group, significant improvement in Barthel and Fugl-Meyer indices and dynamometers has been observed (P = 0.01, P = 0.00, P = 0.007).

Conclusions

rTMS can improve hand muscle force and functions of patients with chronic hemiplegia, while conventional treatment is not effective.

Patients and Methods

In this study, 12 patients with hemiplegia were randomly divided in two groups. Control group, received the rehabilitation program with placebo magnetic stimulation, and the experimental group, received magnetic stimulation with routine rehabilitation program for 10 sessions for three times per week. Pre and post evaluations of treatment performed using Barthel and Fugl-Meyer indices and dynamometers.

Background

Stroke is the most common and debilitating neurological disorder among adults, and is a sudden onset of neurological signs caused by brain blood vessels impairments.

Objectives

Some new therapeutic methods focus on the use of magnetic stimulation to produce therapeutic effects by inducing the currents. The aim of this study is to determine the effects of rTMS plus routine rehabilitation on hand grip and wrist motor functions in patients with hemiplegia, and compare with pure routine rehabilitation programs.

Stroke;Transcranial Magnetic Stimulation;Rehabilitation;Motor Skill Stroke;Transcranial Magnetic Stimulation;Rehabilitation;Motor Skill http://www.ircmj.com/index.php?page=article&article_id=13579 Poopak Motamed Vaziri Poopak Motamed Vaziri Faculty of Medical Sciences, Tarbiat Modares University, Tehran, IR Iran Faculty of Medical Sciences, Tarbiat Modares University, Tehran, IR Iran Farid Bahrpeyma Farid Bahrpeyma Faculty of Medical Sciences, Tarbiat Modares University, Tehran, IR Iran Faculty of Medical Sciences, Tarbiat Modares University, Tehran, IR Iran Mohammad Firoozabadi Mohammad Firoozabadi Department of Medical Physics, Tarbiat Modares University, Tehran, IR Iran Department of Medical Physics, Tarbiat Modares University, Tehran, IR Iran Bijan Forough Bijan Forough School of Medicine, Tehran University of Medical Sciences, Tehran, IR Iran School of Medicine, Tehran University of Medical Sciences, Tehran, IR Iran Boshra Hatef Boshra Hatef Neuroscience Research Center, Baghiyatallah University on Medical Sciences, Tehran, IR Iran Neuroscience Research Center, Baghiyatallah University on Medical Sciences, Tehran, IR Iran Rahman Sheikhhoseini Rahman Sheikhhoseini Department of Physical Education and Sport Sciences, University of Tehran, Tehran, IR Iran; Department of Physical Education and Sport Sciences, University of Tehran, Tehran, IR Iran. Tel: +98-2122790724, +98-9188668284 Department of Physical Education and Sport Sciences, University of Tehran, Tehran, IR Iran; Department of Physical Education and Sport Sciences, University of Tehran, Tehran, IR Iran. Tel: +98-2122790724, +98-9188668284 Aryan Shamili Aryan Shamili Neuroscience Research Center, Tabriz University of Medical Sciences, Tabriz, IR Iran Neuroscience Research Center, Tabriz University of Medical Sciences, Tabriz, IR Iran
en 25389491 10.5812/ircmj.19670 Impact of Maternal Hemoglobin Concentration on Fetal Outcomes in Adolescent Pregnant Women Impact of Maternal Hemoglobin Concentration on Fetal Outcomes in Adolescent Pregnant Women research-article research-article Background

Studies on the association between maternal hemoglobin (Hb) concentration and adverse pregnancy outcome have been inconsistent. Many studies have shown the impact of Hb concentration on pregnancy outcomes in adult women; however, it is not revealed in adolescent pregnant women.

Objectives

The aim of this study was to examine the effect of Hb concentration on birth outcomes in pregnant adolescents as a high-risk group.

Patients and Methods

In this cross-sectional study, 312 healthy and nonsmoker adolescent pregnant women with gestational age (GA) of 37-40 weeks were chosen by random sampling, and were followed until delivery. A complete history was obtained from women. In addition, clinical examination and Hb test were performed. After birth, the associations between Hb concentration during pregnancy and birth outcomes were investigated. Statistical analyses were performed using SPSS software by t-test, chi-square and ANOVA.

Results

In total, about 23.2 % were anemic, 58% had normal level of Hb (11-13.2 g/dL) and 18.8% had Hb > 13.2 g/dL. The mean birth weight was 3197.8 ± 398.25 grams and it was more in mothers with Hb = 10.5-12.5 g/dL than others (Hb < 10.5 or Hb > 12.5 g/dL) (P < 0.001). The lowest mean birth weight was found in mothers with Hb < 10.5 (3033.33 ± 422). Moreover, the mean birth weight of male newborns was more than females (P = 0.001). Eight percent of neonates had Apgar score less than eight. Low Apgar score in anemic group and mothers with high Hb concentration (Hb > 12.5 g/dL) was more than others.

Conclusions

Abnormal Hb concentrations increase the risk of adverse birth outcomes such as low birth weight (LBW) and low Apgar scores in pregnant adolescents, so intensive care is recommended for this group of pregnant women.

Background

Studies on the association between maternal hemoglobin (Hb) concentration and adverse pregnancy outcome have been inconsistent. Many studies have shown the impact of Hb concentration on pregnancy outcomes in adult women; however, it is not revealed in adolescent pregnant women.

Objectives

The aim of this study was to examine the effect of Hb concentration on birth outcomes in pregnant adolescents as a high-risk group.

Patients and Methods

In this cross-sectional study, 312 healthy and nonsmoker adolescent pregnant women with gestational age (GA) of 37-40 weeks were chosen by random sampling, and were followed until delivery. A complete history was obtained from women. In addition, clinical examination and Hb test were performed. After birth, the associations between Hb concentration during pregnancy and birth outcomes were investigated. Statistical analyses were performed using SPSS software by t-test, chi-square and ANOVA.

Results

In total, about 23.2 % were anemic, 58% had normal level of Hb (11-13.2 g/dL) and 18.8% had Hb > 13.2 g/dL. The mean birth weight was 3197.8 ± 398.25 grams and it was more in mothers with Hb = 10.5-12.5 g/dL than others (Hb < 10.5 or Hb > 12.5 g/dL) (P < 0.001). The lowest mean birth weight was found in mothers with Hb < 10.5 (3033.33 ± 422). Moreover, the mean birth weight of male newborns was more than females (P = 0.001). Eight percent of neonates had Apgar score less than eight. Low Apgar score in anemic group and mothers with high Hb concentration (Hb > 12.5 g/dL) was more than others.

Conclusions

Abnormal Hb concentrations increase the risk of adverse birth outcomes such as low birth weight (LBW) and low Apgar scores in pregnant adolescents, so intensive care is recommended for this group of pregnant women.

Hemoglobin; Pregnancy Outcome; Pregnancy; Adolescent; Apgar Score; Infant, Newborn Hemoglobin; Pregnancy Outcome; Pregnancy; Adolescent; Apgar Score; Infant, Newborn http://www.ircmj.com/index.php?page=article&article_id=19670 Leila Alizadeh Leila Alizadeh Department of Maternal and Child Health, Ardabil Branch, Islamic Azad University, Ardabil, IR Iran Department of Maternal and Child Health, Ardabil Branch, Islamic Azad University, Ardabil, IR Iran Azam Raoofi Azam Raoofi Department of Health Education and Promotion, School of Public Health, Alborz University of Medical Sciences, Karaj, IR Iran; Department of Health Education and Promotion, School of Health, Alborz University of Medical Sciences, Karaj, IR Iran. Tel/Fax: +98-2188352501 Department of Health Education and Promotion, School of Public Health, Alborz University of Medical Sciences, Karaj, IR Iran; Department of Health Education and Promotion, School of Health, Alborz University of Medical Sciences, Karaj, IR Iran. Tel/Fax: +98-2188352501 Leili Salehi Leili Salehi Department of Health Education and Promotion, School of Public Health, Alborz University of Medical Sciences, Karaj, IR Iran Department of Health Education and Promotion, School of Public Health, Alborz University of Medical Sciences, Karaj, IR Iran Mani Ramzi Mani Ramzi Hematology Reaserch Center, Departement of Hematology and Medical Oncology, Shiraz University of Medical Sciences, Shiraz, IR Iran Hematology Reaserch Center, Departement of Hematology and Medical Oncology, Shiraz University of Medical Sciences, Shiraz, IR Iran
en 25389480 10.5812/ircmj.14133 Importance of Neutrophil Gelatinase-Associated Lipocalin in Differential Diagnosis of Acute and Chronic Renal Failure Importance of Neutrophil Gelatinase-Associated Lipocalin in Differential Diagnosis of Acute and Chronic Renal Failure research-article research-article Conclusions

Serum NGAL levels of ARF and CRF patients were significantly higher than healthy individuals. In addition, NGAL values of patients with CRF were significantly higher than those of ARF. Serum NGAL values can be used to detect renal injury and differentiate ARF and CRF.

Results

Median NGAL levels in patients was 304.50 (29), and 60 (0) in control, which was statistically significant between the two groups (Z = -6.477, P < 0.001). The median NGAL values were 261.50 ± 291 in ARF group and 428.50 ± 294 in CRF group. There was a significant difference in NGAL level between ARF and CRF groups (Z = -2.52, P = 0.012). Median BUN values were 153.46 ± 82.47 in ARF group and 169.40 ± 93.94 in CRF group. There was no significant difference in BUN value between ARF and CRF groups (P > 0.05). Median creatinine values were 2.84 ± 2.95 in ARF group and 4.78 ± 4.32 in CRF group. In serum creatinine values, a significant difference was found between ARF and CRF groups (P < 0.05).

Objectives

In the present study, we aimed to investigate whether blood NGAL level plays a role in the differential diagnosis of acute and chronic renal failure.

Patients and Methods

This was a prospective case-control study. Fifty patients presented to emergency department with acute renal failure (ARF), 30 with chronic renal failure (CRF) and 20 healthy individuals as control group were included in this study. Blood pH, HCO3-, BUN, creatinine and potassium values were evaluated in all patients. Blood NGAL values were evaluated in all groups. BUN, serum creatinine and NGAL values were statistically compared between patients and controls.

Background

Neutrophil Gelatinase-associated Lipocalin (NGAL) protein is easily detected in the blood and urine soon after acute renal injury. NGAL gains features of an early, sensitive and noninvasive biomarker for acute renal injury. Recent evidences suggest that its expression is also increased in CRF reflecting the severity of disease.

Conclusions

Serum NGAL levels of ARF and CRF patients were significantly higher than healthy individuals. In addition, NGAL values of patients with CRF were significantly higher than those of ARF. Serum NGAL values can be used to detect renal injury and differentiate ARF and CRF.

Results

Median NGAL levels in patients was 304.50 (29), and 60 (0) in control, which was statistically significant between the two groups (Z = -6.477, P < 0.001). The median NGAL values were 261.50 ± 291 in ARF group and 428.50 ± 294 in CRF group. There was a significant difference in NGAL level between ARF and CRF groups (Z = -2.52, P = 0.012). Median BUN values were 153.46 ± 82.47 in ARF group and 169.40 ± 93.94 in CRF group. There was no significant difference in BUN value between ARF and CRF groups (P > 0.05). Median creatinine values were 2.84 ± 2.95 in ARF group and 4.78 ± 4.32 in CRF group. In serum creatinine values, a significant difference was found between ARF and CRF groups (P < 0.05).

Objectives

In the present study, we aimed to investigate whether blood NGAL level plays a role in the differential diagnosis of acute and chronic renal failure.

Patients and Methods

This was a prospective case-control study. Fifty patients presented to emergency department with acute renal failure (ARF), 30 with chronic renal failure (CRF) and 20 healthy individuals as control group were included in this study. Blood pH, HCO3-, BUN, creatinine and potassium values were evaluated in all patients. Blood NGAL values were evaluated in all groups. BUN, serum creatinine and NGAL values were statistically compared between patients and controls.

Background

Neutrophil Gelatinase-associated Lipocalin (NGAL) protein is easily detected in the blood and urine soon after acute renal injury. NGAL gains features of an early, sensitive and noninvasive biomarker for acute renal injury. Recent evidences suggest that its expression is also increased in CRF reflecting the severity of disease.

Renal Failure;Chronic;Acute;NGAL Protein Renal Failure;Chronic;Acute;NGAL Protein http://www.ircmj.com/index.php?page=article&article_id=14133 Seda Ozkan Seda Ozkan Department of Emergency Medicine, Diskapi Training and Research Hospital, Ankara, Turkey; Department of Emergency Medicine, Diskapi Training and Research Hospital, Ankara, Turkey. Tel: +90-3125962600, Fax: +90-3524375273 Department of Emergency Medicine, Diskapi Training and Research Hospital, Ankara, Turkey; Department of Emergency Medicine, Diskapi Training and Research Hospital, Ankara, Turkey. Tel: +90-3125962600, Fax: +90-3524375273 Polat Durukan Polat Durukan Department of Emergency Medicine, Faculty of Medicine, Erciyes University, Kayseri, Turkey Department of Emergency Medicine, Faculty of Medicine, Erciyes University, Kayseri, Turkey Cemil Kavalci Cemil Kavalci Department of Emergency Medicine, Faculty of Medicine, Baskent University, Ankara, Turkey Department of Emergency Medicine, Faculty of Medicine, Baskent University, Ankara, Turkey Ali Duman Ali Duman Department of Emergency Medicine, Isparta State Hospital, Isparta, Turkey Department of Emergency Medicine, Isparta State Hospital, Isparta, Turkey Mustafa Burak Sayhan Mustafa Burak Sayhan Department of Emergency Medicine, Faculty of Medicine, Trakya University, Edirne, Turkey Department of Emergency Medicine, Faculty of Medicine, Trakya University, Edirne, Turkey Omer Salt Omer Salt Emergency Department, Yozgat State Hospital, Yozgat, Turkey Emergency Department, Yozgat State Hospital, Yozgat, Turkey Afsin Ipekci Afsin Ipekci Department of Emergency Medicine, Faculty of Medicine, Erciyes University, Kayseri, Turkey Department of Emergency Medicine, Faculty of Medicine, Erciyes University, Kayseri, Turkey
en 25389489 10.5812/ircmj.19368 Comparing the Effect of Two Educational Programs on the Quality of Life of Hemodialysis Patients in Iran Comparing the Effect of Two Educational Programs on the Quality of Life of Hemodialysis Patients in Iran research-article research-article Background

Various researchers have shown that the health level, performance status, and quality of life (QOL) are often less than expected especially in hemodialysis (HD) patients.

Objectives

This study aimed to determine the effect of the two methods of educational programs on health- related QOL (HRQOL) in Iranian HD patients.

Patients and Methods

In this quasi-experimental, pretest-posttest interventional study, we employed each subject as his/her own control. The study was conducted at the dialysis units in three major general hospitals affiliated with Ahvaz Jundishapur University of Medical Sciences. A total of 90 HD patients were randomly allocated to two 45-patient groups of oral and video education programs, respectively. The educational programs included dietary and fluid regimens, the care of fistula and skin, and stress management. HRQOL was assessed in both groups using a Farsi version of the Short Form Health Survey (SF-36) before and after the educational programs. Repeated measures analysis of variance and ANOVA were used for data analysis through SPSS.

Results

SF-36 domains of physical functioning (P < 0.021), role physical (P < 0.031), social functioning (P < 0.001) and mental health (P < 0.001) were significantly increased in both oral and vide education groups after the interventions. There was no difference in the effectiveness of the two educational programs.

Conclusions

Appropriate interventions may potentially lead to improvement in the HRQOL of these patients. Therefore, video education as an effective, inexpensive, simple, and attractive method is recommended for HD patients.

Background

Various researchers have shown that the health level, performance status, and quality of life (QOL) are often less than expected especially in hemodialysis (HD) patients.

Objectives

This study aimed to determine the effect of the two methods of educational programs on health- related QOL (HRQOL) in Iranian HD patients.

Patients and Methods

In this quasi-experimental, pretest-posttest interventional study, we employed each subject as his/her own control. The study was conducted at the dialysis units in three major general hospitals affiliated with Ahvaz Jundishapur University of Medical Sciences. A total of 90 HD patients were randomly allocated to two 45-patient groups of oral and video education programs, respectively. The educational programs included dietary and fluid regimens, the care of fistula and skin, and stress management. HRQOL was assessed in both groups using a Farsi version of the Short Form Health Survey (SF-36) before and after the educational programs. Repeated measures analysis of variance and ANOVA were used for data analysis through SPSS.

Results

SF-36 domains of physical functioning (P < 0.021), role physical (P < 0.031), social functioning (P < 0.001) and mental health (P < 0.001) were significantly increased in both oral and vide education groups after the interventions. There was no difference in the effectiveness of the two educational programs.

Conclusions

Appropriate interventions may potentially lead to improvement in the HRQOL of these patients. Therefore, video education as an effective, inexpensive, simple, and attractive method is recommended for HD patients.

Hemodialysis;Quality of Life;Patient Education;Audiovisual Demonstration;Iran Hemodialysis;Quality of Life;Patient Education;Audiovisual Demonstration;Iran http://www.ircmj.com/index.php?page=article&article_id=19368 Shahram Baraz Shahram Baraz Chronic Diseases Care Research Center, Nursing and Midwifery School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran Chronic Diseases Care Research Center, Nursing and Midwifery School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran Kourosh Zarea Kourosh Zarea Chronic Diseases Care Research Center, Nursing and Midwifery School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran; Chronic Diseases Care Research Center, Department of Nursing, Nursing and Midwifery School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran. Tel/Fax: +98-6113738621 Chronic Diseases Care Research Center, Nursing and Midwifery School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran; Chronic Diseases Care Research Center, Department of Nursing, Nursing and Midwifery School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran. Tel/Fax: +98-6113738621 Bahman Dashtbozorgi Bahman Dashtbozorgi Chronic Diseases Care Research Center, Nursing and Midwifery School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran Chronic Diseases Care Research Center, Nursing and Midwifery School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran
en 25389468 10.5812/ircmj.10016 Risk Factors for Fatal and Nonfatal Road Crashes in Iran Risk Factors for Fatal and Nonfatal Road Crashes in Iran research-article research-article Background

Road traffic injuries are among the leading causes of death in the world and Iran.

Objectives

The aim of this study was to assess the role of age, sex, education, and time of accident on human casualties and mortalities of road crashes in Iran.

Materials and Methods

This study was based on data gathered by Iranian Police Department from the records of road crashes from April 4, 2008 through April 4, 2009. Road crashes are categorized into three types: with no human casualties, with injuries, and with human mortalities.

Results

The largest rate of human causalities was observed in people aged between 25 to 34 years (P < 0.001). Illiterate people had 81% smaller odds of causality in road crashes (P < 0.001) in comparison with those with a kind of academic education. Overall, 73.4% of crashes had happened during the last ten days of a month were with human casualties (P < 0.001) and human casualties rate was slightly higher in crashes happened between 1 AM to 5 AM Fatality rate was slightly higher in the females (OR = 2.6, P = 0.068). The smallest odds of fatality were found in the people aged between 18 to 24 years and the highest odds were seen in people ≥ 55 years of age (P < 0.001). In people with a university education, 61.9% of crashes were with fatality (P = 0.026). In addition, 82.8% of crashes during winter, 60.2% of crashes during autumn, and 35.8% of crashes during summer were with mortalities. Overall, 78.3% of crashes with human casualties that had happened during 1 AM to 5 AM led to mortalities. There was also a significant association between injury and its intensity with fastening seatbelts.

Conclusions

Older age, university degrees, female sex, wintertime, and the time of accident seem to be the most important risk factors in road crashes that lead to fatalities in Iran. Drivers in Iran should be informed and trained regarding these risk factors, which have direct effect on casualties and mortalities in road crashes.

Background

Road traffic injuries are among the leading causes of death in the world and Iran.

Objectives

The aim of this study was to assess the role of age, sex, education, and time of accident on human casualties and mortalities of road crashes in Iran.

Materials and Methods

This study was based on data gathered by Iranian Police Department from the records of road crashes from April 4, 2008 through April 4, 2009. Road crashes are categorized into three types: with no human casualties, with injuries, and with human mortalities.

Results

The largest rate of human causalities was observed in people aged between 25 to 34 years (P < 0.001). Illiterate people had 81% smaller odds of causality in road crashes (P < 0.001) in comparison with those with a kind of academic education. Overall, 73.4% of crashes had happened during the last ten days of a month were with human casualties (P < 0.001) and human casualties rate was slightly higher in crashes happened between 1 AM to 5 AM Fatality rate was slightly higher in the females (OR = 2.6, P = 0.068). The smallest odds of fatality were found in the people aged between 18 to 24 years and the highest odds were seen in people ≥ 55 years of age (P < 0.001). In people with a university education, 61.9% of crashes were with fatality (P = 0.026). In addition, 82.8% of crashes during winter, 60.2% of crashes during autumn, and 35.8% of crashes during summer were with mortalities. Overall, 78.3% of crashes with human casualties that had happened during 1 AM to 5 AM led to mortalities. There was also a significant association between injury and its intensity with fastening seatbelts.

Conclusions

Older age, university degrees, female sex, wintertime, and the time of accident seem to be the most important risk factors in road crashes that lead to fatalities in Iran. Drivers in Iran should be informed and trained regarding these risk factors, which have direct effect on casualties and mortalities in road crashes.

Cross-Sectional Study;Iran;Risk Factors Cross-Sectional Study;Iran;Risk Factors http://www.ircmj.com/index.php?page=article&article_id=10016 Mohammadreza Mehmandar Mohammadreza Mehmandar NAJA Research Center of Traffic Police of Iran, Tehran, IR Iran NAJA Research Center of Traffic Police of Iran, Tehran, IR Iran Hamid Soori Hamid Soori Safety Promotion and Injury Prevention Research Center, Shahid Beheshti University, Tehran, IR Iran Safety Promotion and Injury Prevention Research Center, Shahid Beheshti University, Tehran, IR Iran Mosa Amiri Mosa Amiri NAJA Research Center of Traffic Police of Iran, Tehran, IR Iran NAJA Research Center of Traffic Police of Iran, Tehran, IR Iran Reza Norouzirad Reza Norouzirad Biochemistry Department, Faculty of Medicine, Dezful University of Medical Sciences, Dezful, IR Iran Biochemistry Department, Faculty of Medicine, Dezful University of Medical Sciences, Dezful, IR Iran Mehdi Khabzkhoob Mehdi Khabzkhoob Department of Epidemiology, Faculty of Health, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran; Department of Epidemiology, Faculty of health, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran. Tel: +98-2182401615 Department of Epidemiology, Faculty of Health, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran; Department of Epidemiology, Faculty of health, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran. Tel: +98-2182401615
en 25389487 10.5812/ircmj.19147 The Experiences of “Difficult Life” in Heart Valve Replaced Patients The Experiences of “Difficult Life” in Heart Valve Replaced Patients research-article research-article Background

Several reports, however, not comprehensive, have been presented about the experiences of patients with replaced heart-valve.

Objectives

This study explores the experiences of the patients with heart valve replacement.

Patients and Methods

A qualitative research with a content analysis approach was carried out on the patients with cardiac valve replacement during the year 2012 and 2013. A purposeful sampling using a semi-structured interview and open-ended questions (with the main question of "What problems did you have after the valve replacement?" followed by the exploratory questions) were performed until the data saturation. All interviews were recorded, then transcribed and typed. The data analysis was done according to Grancheim and Lundmen content analysis using the MAXQDA software.

Results

Of 22 interviews taken from 13 participants, 430 codes were taken. Out of them, after deleting the similar items, 162 initial, 18 subcategory, and 5 subsidiary themes (problematic exposure with valve replacement, continuity of some difficulties, aggravation of life problems, insufficient support, and following a perceived care) were extracted. Based on the abstract and deep perception of the categories, the main theme of "difficult life" was explored.

Conclusions

Aggravation and the continuity of some physical problems, and insufficient support after the valve replacement make the life difficult for the patients. Identification of these problems is necessary for planning and improvement of the patients' care, life quality, and survival through consultations, rehabilitation and education.

Background

Several reports, however, not comprehensive, have been presented about the experiences of patients with replaced heart-valve.

Objectives

This study explores the experiences of the patients with heart valve replacement.

Patients and Methods

A qualitative research with a content analysis approach was carried out on the patients with cardiac valve replacement during the year 2012 and 2013. A purposeful sampling using a semi-structured interview and open-ended questions (with the main question of "What problems did you have after the valve replacement?" followed by the exploratory questions) were performed until the data saturation. All interviews were recorded, then transcribed and typed. The data analysis was done according to Grancheim and Lundmen content analysis using the MAXQDA software.

Results

Of 22 interviews taken from 13 participants, 430 codes were taken. Out of them, after deleting the similar items, 162 initial, 18 subcategory, and 5 subsidiary themes (problematic exposure with valve replacement, continuity of some difficulties, aggravation of life problems, insufficient support, and following a perceived care) were extracted. Based on the abstract and deep perception of the categories, the main theme of "difficult life" was explored.

Conclusions

Aggravation and the continuity of some physical problems, and insufficient support after the valve replacement make the life difficult for the patients. Identification of these problems is necessary for planning and improvement of the patients' care, life quality, and survival through consultations, rehabilitation and education.

Heart Valve Prosthesis;Heart Valve Implantation;Qualitative Research;Life Heart Valve Prosthesis;Heart Valve Implantation;Qualitative Research;Life http://www.ircmj.com/index.php?page=article&article_id=19147 Mohsen Taghadosi Mohsen Taghadosi Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, IR Iran Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, IR Iran Robabeh Memarian Robabeh Memarian Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, IR Iran; Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, IR Iran. Tel: +98-9133634439 Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, IR Iran; Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, IR Iran. Tel: +98-9133634439 Fazlollah Ahmadi Fazlollah Ahmadi Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, IR Iran Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, IR Iran
en 25389492 10.5812/ircmj.19797 Immediate and Delayed Effects of Forearm Kinesio Taping on Grip Strength Immediate and Delayed Effects of Forearm Kinesio Taping on Grip Strength research-article research-article Background

Due to the fundamental role of gripping in most upper limb activities, grip strength promotion is a chief goal in the treatment of patients with upper limb musculoskeletal disorders. Kinesio taping is a novel and effective therapeutic technique believed to facilitate muscle contraction through stimulating mechanoreceptors and increasing the sensory feedback around the taped region.

Objectives

The present study aimed to identify the best region (flexor, extensor and flexor/extensor regions) and time (immediate, 0.5, 1, 1.5, and 2 hours) of forearm Kinesio taping to obtain the maximum improvement in grip strength.

Materials and Methods

In this longitudinal study, 40 healthy men and women (the mean age of 22.3 ± 2.19 years) were selected among students of Shahid Beheshti University of Medical Sciences, Tehran, Iran by simple, nonrandom sampling method. A dynamometer was used to measure grip strength immediately and every 30 minutes during the two hours after I-shaped application of tape (with 50% stretch) to the flexor, extensor, and flexor/extensor forearm muscles.

Results

Grip strength was significantly increased in various muscle groups for males (P = 0.002) and females (P = 0.000) of the forearm and at different intervals for males (P = 0.000) and females (P = 0.000). Moreover, in both men and women, tape application to the extensor region provided greater grip strength compared to taping of the flexor and flexor/extensor regions (P = 0.000 for both). Furthermore, the maximum increase in grip strength were 0.5 (10.8% increase, P = 0.001) and 1.5 h (23.9% increase, P = 0.000) after taping in males and females, respectively.

Conclusions

Taping the extensor region of forearm is recommended to achieve higher grip strength. Although grip strength increased at a slower pace in females than males, the final values were higher in women.

Background

Due to the fundamental role of gripping in most upper limb activities, grip strength promotion is a chief goal in the treatment of patients with upper limb musculoskeletal disorders. Kinesio taping is a novel and effective therapeutic technique believed to facilitate muscle contraction through stimulating mechanoreceptors and increasing the sensory feedback around the taped region.

Objectives

The present study aimed to identify the best region (flexor, extensor and flexor/extensor regions) and time (immediate, 0.5, 1, 1.5, and 2 hours) of forearm Kinesio taping to obtain the maximum improvement in grip strength.

Materials and Methods

In this longitudinal study, 40 healthy men and women (the mean age of 22.3 ± 2.19 years) were selected among students of Shahid Beheshti University of Medical Sciences, Tehran, Iran by simple, nonrandom sampling method. A dynamometer was used to measure grip strength immediately and every 30 minutes during the two hours after I-shaped application of tape (with 50% stretch) to the flexor, extensor, and flexor/extensor forearm muscles.

Results

Grip strength was significantly increased in various muscle groups for males (P = 0.002) and females (P = 0.000) of the forearm and at different intervals for males (P = 0.000) and females (P = 0.000). Moreover, in both men and women, tape application to the extensor region provided greater grip strength compared to taping of the flexor and flexor/extensor regions (P = 0.000 for both). Furthermore, the maximum increase in grip strength were 0.5 (10.8% increase, P = 0.001) and 1.5 h (23.9% increase, P = 0.000) after taping in males and females, respectively.

Conclusions

Taping the extensor region of forearm is recommended to achieve higher grip strength. Although grip strength increased at a slower pace in females than males, the final values were higher in women.

Athletic Tape;Hand Strength;Forearm Athletic Tape;Hand Strength;Forearm http://www.ircmj.com/index.php?page=article&article_id=19797 Hosein Kouhzad Mohammadi Hosein Kouhzad Mohammadi Department of Physical Therapy, Faculty of Rehabilitation Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Department of Physical Therapy, Faculty of Rehabilitation Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Khosro Khademi Kalantari Khosro Khademi Kalantari Department of Physical Therapy, Faculty of Rehabilitation Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran; Department of Physical Therapy, Faculty of Rehabilitation Sciences, Shahid Beheshti University of Medical Sciences. Opposite to Bou-Ali Hospital, Damavand Avenue, Postal Code: 1616913111. Tehran, IR Iran. Tel: +98-2177561407, Fax: +98-2177561406 Department of Physical Therapy, Faculty of Rehabilitation Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran; Department of Physical Therapy, Faculty of Rehabilitation Sciences, Shahid Beheshti University of Medical Sciences. Opposite to Bou-Ali Hospital, Damavand Avenue, Postal Code: 1616913111. Tehran, IR Iran. Tel: +98-2177561407, Fax: +98-2177561406 Sedighe Sadat Naeimi Sedighe Sadat Naeimi Department of Physical Therapy, Faculty of Rehabilitation Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Department of Physical Therapy, Faculty of Rehabilitation Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Mohammad Pouretezad Mohammad Pouretezad Department of Physical Therapy, Faculty of Rehabilitation Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran Department of Physical Therapy, Faculty of Rehabilitation Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran Esmaeil Shokri Esmaeil Shokri Department of Physical Therapy, Faculty of Rehabilitation Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran Department of Physical Therapy, Faculty of Rehabilitation Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran Mojdeh Tafazoli Mojdeh Tafazoli Department of Physical Therapy, Faculty of Rehabilitation Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran Department of Physical Therapy, Faculty of Rehabilitation Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran Mahboobeh Dastjerdi Mahboobeh Dastjerdi Department of Physical Therapy, Faculty of Rehabilitation Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran Department of Physical Therapy, Faculty of Rehabilitation Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran Leila Kardooni Leila Kardooni Department of Physical Therapy, Faculty of Rehabilitation Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran Department of Physical Therapy, Faculty of Rehabilitation Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran
en 25389494 10.5812/ircmj.21110 The Effect of Group Discussion on the Quality of Life and HbA1c Levels of Adolescents With Diabetes The Effect of Group Discussion on the Quality of Life and HbA1c Levels of Adolescents With Diabetes research-article research-article Background

Diabetes is a metabolic syndrome and the most common endocrine disorder in childhood and adolescence. Diabetes occurs at any age but the highest outbreak is during ten to 15 years of age and 75% of the cases are diagnosed at the age 18.

Objectives

This study aimed to investigate the effect of a group discussion on the quality of life (QOL) and glycosylated hemoglobin A (HbA1c) levels of adolescents with diabetes.

Patients and Methods

This quasi-experimental study was performed on 56 adolescents with diabetes who were referred to Golabchi Diabetes Center in Kashan, Iran. After obtaining written informed consent from the patients, blood sample was drawn for measuring sugar and HbA1c levels. The participants completed the questionnaire regarding the QOL. Patients were randomly allocated to four groups. All the groups attended similar group discussion sessions, which were conducted according to the guidance of diabetic specialists. The groups’ members followed the discussed instructions for four months. Then, another questionnaire was completed and blood sugar and HbA1c levels were measured again. The results were compared by paired-samples t-test and Wilcoxon signed-rank test.

Results

After the group discussion sessions, in 56% of the patients the HbA1c levels (8.45 ± 1.35 and 6.98 ± 0.89 before and after intervention, respectively) and QOL were improved significantly. The mean age of these patients was 14.75 ± 1.80 years and the mean of daily insulin injection was 35.70 ± 13.42 units.

Conclusions

Sharing experiences trough group discussions and receiving instructive feedbacks can improve the QOL and metabolic status of adolescents with diabetes.

Background

Diabetes is a metabolic syndrome and the most common endocrine disorder in childhood and adolescence. Diabetes occurs at any age but the highest outbreak is during ten to 15 years of age and 75% of the cases are diagnosed at the age 18.

Objectives

This study aimed to investigate the effect of a group discussion on the quality of life (QOL) and glycosylated hemoglobin A (HbA1c) levels of adolescents with diabetes.

Patients and Methods

This quasi-experimental study was performed on 56 adolescents with diabetes who were referred to Golabchi Diabetes Center in Kashan, Iran. After obtaining written informed consent from the patients, blood sample was drawn for measuring sugar and HbA1c levels. The participants completed the questionnaire regarding the QOL. Patients were randomly allocated to four groups. All the groups attended similar group discussion sessions, which were conducted according to the guidance of diabetic specialists. The groups’ members followed the discussed instructions for four months. Then, another questionnaire was completed and blood sugar and HbA1c levels were measured again. The results were compared by paired-samples t-test and Wilcoxon signed-rank test.

Results

After the group discussion sessions, in 56% of the patients the HbA1c levels (8.45 ± 1.35 and 6.98 ± 0.89 before and after intervention, respectively) and QOL were improved significantly. The mean age of these patients was 14.75 ± 1.80 years and the mean of daily insulin injection was 35.70 ± 13.42 units.

Conclusions

Sharing experiences trough group discussions and receiving instructive feedbacks can improve the QOL and metabolic status of adolescents with diabetes.

Focus Groups;Diabetes Mellitus;Adolescents;Quality of life;Glycosylated Hemoglobin A Focus Groups;Diabetes Mellitus;Adolescents;Quality of life;Glycosylated Hemoglobin A http://www.ircmj.com/index.php?page=article&article_id=21110 Mohamad Afshar Mohamad Afshar Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, IR Iran Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, IR Iran Robabe Memarian Robabe Memarian Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, IR Iran; Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, IR Iran. Tel: +98-9121594663 Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, IR Iran; Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, IR Iran. Tel: +98-9121594663 Esa Mohammadi Esa Mohammadi Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, IR Iran Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, IR Iran