Research articles
Kazem Akhondzadeh; Tahereh Najafi Ghezeljeh; Hamid Haghani
Volume 20, s1 , December 2018, Pages 1-10
Abstract
Background: High sodium intake can increase the symptoms of patients with chronic heart failure.Objectives: To examine the effect of the education program on the adherence intention to the dietary sodium restriction and sodium intake in patients with chronic heart failure hospitalized in a teaching hospital ...
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Background: High sodium intake can increase the symptoms of patients with chronic heart failure.Objectives: To examine the effect of the education program on the adherence intention to the dietary sodium restriction and sodium intake in patients with chronic heart failure hospitalized in a teaching hospital affiliated with Yazd University of medical sciences, Yazd, Iran from January to July 2016. Methods: This controlled randomized clinical trial was conducted on 100 patients suffering from chronic heart failure. Block ran- domization was used to assign the patients to the intervention and control groups. In addition to routine education, the patients in the intervention group and one of their family members participated in the education program for 6 consecutive weeks. The amount of sodium intake in a 24-hour period was measured. A urine sample was collected for the measurement of the secondaryoutcome. A questionnaire was used for data collection about the evaluation of the adherence intention to the dietary sodium re- striction. Results: There were statistically significant differences between the intervention (2539.40 ± 1130.03) and control (3016.80 ± 790.38) groups in terms of the sodium intake 6 weeks after the intervention (P = 0.0023). Also, statistically significant differences were re- ported between these groups (2601.84 ± 1128.43 and 3041.95 ± 789.75 in the intervention and control group, respectively, P = 0.036) 12 weeks after the intervention. Six and 12 weeks after the education program, statistically significant differences were found be- tween the groups in terms of the attitude (P < 0.001), subjective norm toward the restricted-sodium diet (P < 0.001), and perceived behavioral control (P < 0.001).Conclusions: The education program promoted the adherence intention to the dietary sodium restriction among patients with chronic heart failure, which subsequently led to the sodium intake reduction.
Research articles
Tülay Tarsuslu ¸Sim¸sek; Eylem Tütün Yümin; Meral Sertel
Volume 20, s1 , December 2018, Pages 1-9
Abstract
Background: Changes in body composition in advanced ages (i.e., physical, physiological, and social changes) may influence the perception of body image in the elderly population. In some studies, it is stated that negative body image is associated with the consequences of unhealthy physical and mental ...
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Background: Changes in body composition in advanced ages (i.e., physical, physiological, and social changes) may influence the perception of body image in the elderly population. In some studies, it is stated that negative body image is associated with the consequences of unhealthy physical and mental health status. Objectives: The purpose of the study is to examine changes in body weight, body satisfaction, and quality of life in the elderly. Methods: This descriptive analytical study was performed from July 2015 to April 2016 on individuals aged 45 years and above wholived in Kirikkale, Turkey. The participants were divided into four age groups of 45 - 59 years (group 1), 60 - 69 years (group 2), 70 - 79 years (group 3), and 80 years and above (group 4). Body satisfaction was evaluated using Body-Cathexis Scale (BCS), and the quality of life was evaluated using the Nottingham Health Profile (NHP). Results: the highest body mass index (BMI) was found in the 60 - 69 years age group (29 ± 4.72 kg/cm2), whereas the lowest scorewas found to be in the individuals pertaining to the 80 years and above age group (26.53 ± 4.53 kg/cm2). BCS total scores were 85.95 ± 22.09 in group 1, 94.78 ± 26.68 in group 2, 103.29 ± 31.41 in group 3, and 107.28.35.84 in group 4. A significant difference was found between the groups in terms of quality of life and body satisfaction (P < 0.05). There was a positive correlation between BCS and NHP in groups 1, 2, and 3 (P < 0.05). However, there was no correlation between BCS and NHP in group 4 (P > 0.05). Conclusions: Evaluations and practices performed for body weight control in middle-aged and older adults are of importance in terms of increasing the quality of life.
Siros Norozi; Masoumeh Shohani; Hamed Tavan
Volume 20, s1 , December 2018, Pages 1-2
Research articles
Mahnaz Yadollahi; Ali Kashkooe; Ehsan Habibpour; Kazem Jamali
Volume 20, s1 , December 2018, Pages 1-7
Abstract
Background: Spinal trauma is a devastating event which could disturb a person’s life. Objectives: The purpose of this study was to examine the prevalence and risk factors of spinal trauma in Rajaee Trauma Center, Shiraz, Iran.Methods: Data for this cross-sectional study were gathered from October ...
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Background: Spinal trauma is a devastating event which could disturb a person’s life. Objectives: The purpose of this study was to examine the prevalence and risk factors of spinal trauma in Rajaee Trauma Center, Shiraz, Iran.Methods: Data for this cross-sectional study were gathered from October 2009 to August 2015. The study was conducted through data extraction from the classified data of trauma patients admitted to Rajaei hospital. After performing some inclusion and ex- clusion criteria, 4630 cases were analyzed. The variables analyzed as the risk factors of spinal trauma included sex, age, cord injury, mechanism of injury, and injury severity score. Results: The prevalence of spinal trauma among traumatic patients was 7%; also, 3.7% of those with spinal trauma suffered cord injury. The mean age of the spinal traumatic patients was 38.2 ± 17.8, and male-to-female ratio was 2.394. Car accident, motorbikeaccident, and fall were the main causes of spinal trauma in this study. The lumbar region was the most common injured site in our study. Old age, cord injury, suicide, and car accident were the main risk factors of mortality among spinal traumatic patients. Risk factors of spinal trauma among traumatic patients were female gender, old age, and fall. The risk factors of cord injury in spinal traumatic patients were male gender, old age, and suicide. Conclusions: It was found that spinal trauma, spinal cord injury (SCI), and mortality among spinal traumatic patients in Iran de- pended on some risk factors, which should be reduced through eliminating such risk factors. Fall was the most prominent factor ofthe occurrence of spinal trauma. The most important factors of mortality in spinal traumatic patients were suicide and cord injury. Finally, suicide played the most important role in occurrence of SCI.
Research articles
Nasibeh Sharifi; Mahrokh Dolatian; Zohreh Mahmoodi; Fatemeh Mohammadi Nasrabadi; Yadollah Mehrabi
Volume 20, s1 , December 2018, Pages 1-1
Editorial
Ali Nazari; Gholamreza Noori; Elham Mohammadyari; Gholamreza Taebi; Hamed Tavan
Volume 20, s1 , December 2018, Pages 1-2
Research articles
Hulya Yucel; Omer Uysal
Volume 20, s1 , December 2018, Pages 1-7
Abstract
Background: Physical exercises increase quality of life (QoL) in diabetics. However, the optimal exercise type for patients with diabetes has not yet been established. It is unknown whether pilates is a suitable form of exercise for the QoL of patients with diabetes. Objectives: The aim of this study ...
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Background: Physical exercises increase quality of life (QoL) in diabetics. However, the optimal exercise type for patients with diabetes has not yet been established. It is unknown whether pilates is a suitable form of exercise for the QoL of patients with diabetes. Objectives: The aim of this study was to investigate effects of Pilates-based mat exercise (PBME) on glycemic control, anxiety, de- pression, and QoL in women with type 2 diabetes. Materials and Methods: This prospective and randomized study was conducted with 24 women in the Pilates group and 21 womenin the control group. Socio demographic data were collected from both groups, including the duration of diabetes since diagnosis, medications being taken, insulin injections, sleep problems, and so on, as well as hospital records of blood laboratory test outcomes (fasting blood glucose, postprandial blood glucose, and glycosylated hemoglobin). Pain and fatigue symptoms were assessed using the visual analogue scale. Participants completed the 36-item short form health survey and the hospital anxiety depression scale. Participants in the exercise group performed PBME three times per week for 12 weeks. Both groups continued their routine diet and medical follow-ups during the intervention. Data from the groups were compared before and after the program. Results: Pain (3.00 ± 4.00, 2.00 ± 2.00, P = 0.001), fatigue (5.00 ± 2.00, 4.00 ± 1.00, P = 0.0001), mental health-related QoL (29.00 ± 5.00, 35.00 ± 3.00, P = 0.0001), anxiety (8.00 ± 3.00, 7.00 ± 3.00, P = 0.023), depression (9.00 ± 2.00, 8.00 ± 2.00, P = 0.019), fasting blood glucose (140.00 ± 31.00, 139.5 ± 32.00, P = 0.026), and glycosylated hemoglobin values (6.70 ± 1.16, 6.30±1.00, P = 0.001) inthe Pilates group differed before and after the intervention. In the control group, only glycosylated hemoglobin values (6.53 ± 1.42, 6.40 ± 1.27, P = 0.008) differed before and after the intervention. Conclusions: PBMEs affect the parameters of QoL in women with type 2 diabetes, and they might be recommended as a part of their treatment program
Research articles
Mohammad Arash Ramezani; Khodabakhsh Ahmadi; Afagh Ghaemmaghami; Somayeh Zamani; Seyed Hassan Saadat; Seyed Peyman Rahiminejad
Volume 20, s1 , December 2018, Pages 1-7
Abstract
Background: Quality-of-life therapy (QOLT) is an integrative psychotherapy that was formed by adding positive psychology con- cepts to cognitive-behavior therapy (CBT). Objectives: The aim of the current study was to evaluate the efficacy of QOLT on the sexual self-concept of Iranian women. Patients ...
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Background: Quality-of-life therapy (QOLT) is an integrative psychotherapy that was formed by adding positive psychology con- cepts to cognitive-behavior therapy (CBT). Objectives: The aim of the current study was to evaluate the efficacy of QOLT on the sexual self-concept of Iranian women. Patients and Methods: A double-blind randomized experimental study was done from February 2011 to January 2012. The study subjects were recruited from a mental health nongovernmental organization in Isfahan, Iran. They were assigned randomly to two groups. The first group was under ten sessions of QOLT, and the second, as a control group, was under psycho-sexual education (PSE). General Health Questionnaire-28 (GHQ-28), the Multidimentional Sexual Self-Concept Questionnaire, and the Female SexualFunction Index (FSFI) were completed for participants before and after the intervention. The ANCOVA model was used for analysis. Results: The findings revealed no significant differences between the two groups in mental health (GHQ-28 scores) and female sexual dysfunction, but sexual self-concept changed. Two subscales of sexual self-concept, sexual monitoring (QOLT group = 6.3 ± 2.7 vs PSE group = 4.7 ± 3.1 P < 0.05) and sexual-problem management (QOLT group = 15.4 ± 3.8 vs PSE group=13.7 ± 3.9 P < 0.05), increased significantly during QOLT. Conclusions: QOLT did not impact mental health, but it could change many dimensions of sexual self-concept.
Research articles
Masoumeh Sarbaz; Hamid Reza Naderi; Mohammad Hassan Aelami; Saeid Eslami
Volume 20, s1 , December 2018, Pages 1-8
Abstract
Background: Physicians continually need to update their knowledge to ensure appropriate decision making about patient care. Objectives: We aimed to identify and compare information sources used by specialists and residents, their reasons for choosing these sources, and the level of their confidence in ...
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Background: Physicians continually need to update their knowledge to ensure appropriate decision making about patient care. Objectives: We aimed to identify and compare information sources used by specialists and residents, their reasons for choosing these sources, and the level of their confidence in these sources. Materials and Methods: We conducted a cross-sectional study among specialists and residents using a validated questionnaire in the five academic hospitals affiliated with Mashhad University of Medical Sciences (in northeast Iran). We compared the specialistswith residents in term of gender, age, years since graduation, use of information sources, confidence in use of information sources, and reasons for selecting the information sources. Within each group, we also investigated the effect of work experience and gender on frequently used information sources and users’ confidence in them. Results: The questionnaire was sent to 315 physicians, including 155 specialists and 160 residents. One hundred twenty-six specialists(response rate: 81 %) and 126 residents (response rate: 79%) completed it. The most frequently mentioned sources by all specialists included “English textbooks” (84.9%), “web/internet” (74.6%), “English medical journals” (62.3 %), and “discussions with colleagues” (57%). Among residents, “web/internet” (65.9%), “discussion with colleagues” (61.3%), and “Persian textbooks” (50.4%) were the most frequently used sources of information. In both groups, high confidence was demonstrated in “English textbooks,” “English medical journals,” and “international instructions/guidelines.” Both groups counted reliability, easy accessibility, and being up to date as their primary reasons for the selection of their information sources. There was also a significantly negative correlation between using the internet as an information source and age in specialists (Spearman’s rho=- 0.238, p=0.01), but not in residents. Conclusions: Reliability, easy accessibility, and being up to date should be considered in establishing information sources for physi- cians.
Research articles
Mohammad Hassan Abolhassani; Fariba Kolahdooz; Reza Majdzadeh; Mohammadreza Eshraghian; Roksana Mirkazemi; Abolghasem Djazayery
Volume 20, s1 , December 2018, Pages 1-8
Abstract
Background: Monitoring of food insecurity is a critical issue for planners and policymakers in the public and private sectors in developing countries. Due to the multifactorial and multidimensional nature of food security and a lack of clarity concerning the causes, specific signs, and consequences of ...
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Background: Monitoring of food insecurity is a critical issue for planners and policymakers in the public and private sectors in developing countries. Due to the multifactorial and multidimensional nature of food security and a lack of clarity concerning the causes, specific signs, and consequences of food insecurity, developing a reliable food security index is the major challenge related to monitoring food security. Objectives: The objective of this study was to identify the most appropriate indicators of food security at the provincial level in Iran through the application of an integrated approach including Delphi (classic Delphi) and analytic hierarchy process (AHP) from March to September 2013.Materials and Methods: The sample included 43 senior-level managers and experts at the national and provincial levels from dif- ferent fields of related sciences; they were selected purposively as Delphi and AHP panel members based on the experts’ opinions and snowballing. In the first round of Delphi, out of 103 identified indicators, 38 were selected by the experts; the indicators were ranked in the second round. In the AHP study, 25 experts assigned weights in a pairwise comparison of the 20 indicators that had the highest priority based on the Delphi results. Using AHP matrix calculations, this list of indicators was ranked based on priority. Results: Out of 38 indicators identified in Delphi, 8 were related to the availability dimension, 14 were related to the access dimen- sion, and 16 were related to the utilization dimension. Out of 20 indicators that were ranked in the AHP study, 6 indicators were related to availability, 7 were related to utilization, and 7 were related to access dimensions. However, the indicators related to avail- ability had an overall higher rank compared to indicators related to access or utilization. Conclusions: This study identified and ranked 20 indicators as the most appropriate indicators of food security measurements at the provisional level in Iran.
Research articles
Reza Mahdavi; Fatemeh Ghannadiasl; Mohammad Asghari Jafarabadi
Volume 20, s1 , December 2018, Pages 1-8
Abstract
Background: The use of weight-loss dieting has always been overemphasized as the first modality to treat obesity. Success in weight loss is considered a major problem in obese individuals. The processes of behavior change have been used to facilitate intervention promoting change. Only a minority of ...
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Background: The use of weight-loss dieting has always been overemphasized as the first modality to treat obesity. Success in weight loss is considered a major problem in obese individuals. The processes of behavior change have been used to facilitate intervention promoting change. Only a minority of studies have employed this construct for weight loss.Objectives: The purpose of this study was to assess the effect of a balanced low-calorie diet with or without nutrition education on the weight loss and processes of change among obese women. Methods: In a randomized clinical trial, 90 apparently healthy obese women age 18 - 50 with body mass index (BMI) of 30 - 40 kg/m2 were recruited from the nutrition clinic in Ardabil, located in the northwest of Iran. Participants were assigned randomly to receivea balanced low-calorie diet with or without nutrition education. Participants completed a processes of change questionnaire at baseline and at three and six months after intervention. A generalized linear model repeated measures analysis of variances was used to assess the time effect as well as the interaction between the time and the group effect.Results: Significant differences were found in the time effect for weight (F = 12.64, df = 2, P < 0.001), BMI (F = 10.90, df = 2, P = 0.001), andcounterconditioning (F = 22.82, df = 2, P < 0.001), and helping relationships (F = 5.47, df = 2, P = 0.006), reinforcement management (F = 3.65, df = 2, P = 0.03), self-liberation (F = 5.05, df = 2, P = 0.008), stimulus control (F = 12.12, df = 2, P < 0.001), and substance abuse subscales (F = 6.72, df = 2, P = 0.002). Significant differences were shown in interaction time and group effect for weight (F = 5.69, df = 2, P = 0.011), BMI (F = 4.91, df = 2, P = 0.018) and counterconditioning (F = 5.11, df = 2, P = 0.008) and stimulus control (F = 5.50, df = 2, P = 0.006) subscales. Conclusions: The findings support the use of nutrition education for more weight loss and improvement in the counter condition- ing and stimulus control subscales among obese women attending the nutrition clinic. It seems that nutrition education should be considered important in effective weight-loss interventions.
Research articles
Mahdi Javid; Mohammad Hadian; Aziz Rezapour; Masoud Salehi; Mehdi Toroski
Volume 20, s1 , December 2018, Pages 1-5
Abstract
Background: A cost-effectiveness analysis is used to evaluate and compare the cost versus the benefits of different treatment modal- ities. The clinical effectiveness of laparoscopic cholecystectomy has been well documented. To our knowledge, there was no pub- lished data on the cost-utility of laparoscopic ...
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Background: A cost-effectiveness analysis is used to evaluate and compare the cost versus the benefits of different treatment modal- ities. The clinical effectiveness of laparoscopic cholecystectomy has been well documented. To our knowledge, there was no pub- lished data on the cost-utility of laparoscopic cholecystectomy in Iran. Objectives: This study aimed to compare the cost-utility of the two surgical methods for removing gallstones: open cholecystec-tomy and laparoscopic cholecystectomy. Patients and Methods: In this comparative cross-sectional analysis, we investigated the data of patients who had undergone la- paroscopic and open cholecystectomy operations in Kashani hospital, Iran, between 2012 and 2014. Using the available samples, two groups of 30 patients were randomly selected. SF-36 was used to assess the quality of life (QoL) of patients 30 to 35 days af- ter operation, and quality-adjusted life years (QALYs) were calculated by multiplying the SF-36 score by healthy years of life. An activity-based costing method was used to determine the costs of the operations. The cost-effectiveness ratio (CER) was calculatedby dividing the costs of each method by the gained QALY. To determine the difference between the two surgical methods, we used independent-samples t test. Results: The data of 60 patients, 40 men and 20 women, with the mean age of 54.30 ± 16.44 in the laparoscopic group and 51.77 ± 18.41 in the open cholecystectomy group were analyzed. The mean cost of surgery was lower in the laparoscopy group (2259 ± 895 USD) than in the laparotomy group (2972 ± 907.9 USD) (P = 0.003). The mean SF-36 score was higher in the laparoscopic group (65.98 ± 9.22) than in the open cholecystectomy group (58.03 ± 11.30) (P < 0.004). The cost of gaining QALY was also significantlylower in the laparoscopic group. The mean of the gained QALY index was 1.79 ± 0.29 and 1.14 ± 0.41 for the laparoscopic and open surgeries, respectively (P < 0.001). The incremental CER was 1067 USD for each QALY for the laparoscopic group in comparison to the value of open cholecystectomy. Conclusions: Laparoscopic cholecystectomy was more cost-effective than open cholecystectomy and is therefore preferred and recommended in patients with gallstones.
Case reports
Masood Amini; Mohammadhassan Hashemizadeh; Hadi Hadavi; Masood Sepehrimanesh; Maryam Setoodeh
Volume 20, s1 , December 2018, Pages 1-4
Abstract
Introduction: Herniation of the stomach through the esophageal hiatus into the thoracic cavity is a common affliction in modern humans. Its incidence in North America has ranged from 10% to 80%. However, approximately complete herniation of the stomach is scarce. Therefore, we discussed this unusual ...
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Introduction: Herniation of the stomach through the esophageal hiatus into the thoracic cavity is a common affliction in modern humans. Its incidence in North America has ranged from 10% to 80%. However, approximately complete herniation of the stomach is scarce. Therefore, we discussed this unusual case. Case Presentation: A 43-year-old man with a hypochromic, microcytic, iron-deficient anemia picture, postprandial and postex- ercise respiratory failures, and epigastric pain was examined by a gastroenterologist in the outpatient clinic of mother and childspecialized hospital in Shiraz, Iran in November 2015. Left thorax hemiatrophy was obvious upon physical examination. Positive Helicobacter pylori, peripyloric erythema, and mild chronic active gastritis were diagnosed after an upper gastrointestinal (GI) en- doscopy and colonoscopy. In a barium-swallow upper GI series, malrotation of most of the patient’s stomach and the stomach’s dislocation in to the thoracic cavity were detected. A CT scan also showed a large hiatus hernia with a large part of the stomach in- serted in the defect. The patient revealed a history of a motorcycle accident about 28 years earlier. After the administration of general anesthesia and the semilateral positioning of the patient, five ports were inserted (three 5 mm and two 10 mm). The stomach was relocated into the abdominal cavity, and the bloody sac was dissected from the left and then the right cross, detached from the tho- racic cavity, and completely removed. Two cruses were sutured together using a 1/0 silk suture, and after releasing the short gastrics,a prophylactic Dor fundoplication was performed. The next morning, oral nutrition was started, and the patient was discharged in a good general health condition. Conclusions: Laparoscopic repair of a large hiatus hernia plus Dor fundoplication is an effective method of treatment of such a defect without any symptoms. However, it may be associated with the mild to moderate prevalence of recurring hernias.
Research articles
Zohreh Azarkar; Azadeh Ebrahimzadeh; Gholamreza Sharifzadeh; Masood Ziaee; Mohammad Fereidouni
Volume 20, s1 , December 2018, Pages 1-5
Abstract
Background: Hepatitis E infection is one of the most common causes of acute hepatitis. It is caused by the RNA virus of the hep- atomegaly viridae family, which is transferred through stool in contaminated water. Cases of infection are most prevalent in devel- oping countries. Objectives: This study ...
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Background: Hepatitis E infection is one of the most common causes of acute hepatitis. It is caused by the RNA virus of the hep- atomegaly viridae family, which is transferred through stool in contaminated water. Cases of infection are most prevalent in devel- oping countries. Objectives: This study was conducted to investigate the seroprevalence of hepatitis E among urban adults. The reason was the current lack of information on the hepatitis E prevalence among the general population in the city of Birjand in eastern Iran. This information is necessary because Southern Khorasan is in close proximity to Afghanistan. Methods: In this cross sectional study, 522 participants aged over 17 years were selected from the city of Birjand, eastern Iran, using the random cluster sampling. The participants completed a researcher-made questionnaire that included demographic character- istics, risk factors for infectious diseases such as records of blood transfusions, specific exposures, intravenous drug abuse, recent diagnosis or a history of liver disease, and other medical information. After selection, a blood sample was taken from each partic- ipant to a volume of 5 cc. Each blood sample was then measured for the title of IgG antivirus of hepatitis E by the enzyme-linked immunosorbent assay (ELISA) method using the third generation ELISA kit made by Delavara Company. Results: This study included 554 participants. The mean age of the participants was 41.4 years (age range, 17 - 72 years). From a total of 554 participants, 295 (53.2%) were females and the remainder were males. Results showed that the hepatitis E antibody title waspositive in 139 (25.1%) participants and negative in the others. Comparison of the prevalence rates of positive HEV between men and women showed no statistically significant difference although it was significantly higher in married participants than in single ones (P < 0.001). Results also showed that the prevalence was less in participants with a tertiary education compared to those with a lower level education. Along with age, the prevalence of the positive antibody title increased significantly. The prevalence of HEV in participants who were smokers was significantly (P < 0.001) lower than in those who were nonsmokers. Conclusions: In this study, the seroprevalence of contact with HEV in urban adults in the city of Birjand was 25%. The results of this study showed that the prevalence of hepatitis E in the city of Birjand, eastern Iran, was higher than in other places compared with previous studies on communities in Iran. Also, the prevalence of HEV in single and educated people was significantly less than that in married and literate individuals.
Research articles
Azita Kiani Asiabar; Farkhondeh Amin Shokravi; Majid Hajifaraji; Farid Zayeri
Volume 20, s1 , December 2018, Pages 1-12
Abstract
Background: Spouses can influence their wife’s health during pregnancy. However, dietary intake comprised of high value nu- trition in addition to spouses’ participation during pregnancy is an important aspect of female’s health, which has been widely neglected. Objectives: This study ...
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Background: Spouses can influence their wife’s health during pregnancy. However, dietary intake comprised of high value nu- trition in addition to spouses’ participation during pregnancy is an important aspect of female’s health, which has been widely neglected. Objectives: This study aimed at evaluating the effectiveness of educational programs with spouse’s participation on dietary during pregnancy. Methods: In the randomized controlled trial study, 128 nulliparous females attending Najmieh hospital based in Tehran, Iran, were randomly allocated to 2 intervention and 1 control group. In Group A, females received nutritional education with their spouses’ participation, in Group B, females received nutritional education alone, and in Group C, females received routine prenatal care, yet no guidance on dietary intake. Data was collected by completing 2 questionnaires, including demographic characteristics and the semi-quantitative food frequency questionnaire (FFQs). Results: In this trial study, the mean differences of serving/day of vegetables and yogurt from the dairy range was significantly higher in group A compared to B and the control group (1.27 serving/day vegetables - group A compared to 0.81 and 0.41 serving/day vegetables in groups B and C, respectively; P < 0.001, and 0.56 serving/day of yogurt in group A versus 0.33 and 0.32 serving/day of yogurt in groups B and C, respectively, P < 0.024). The mean differences of serving/day of dairy in groups A and B were significantly higher than the control group (1.97 and 1.66 serving/day in groups A and B, respectively versus 0.81 serving/day in the group C, P = 0.003). In addition, the mean differences of serving/day for fat sources in the intervention groups were significantly lower than thecontrol group (2.58 and 1.18 serving/day in groups A and B, respectively versus 0.38 serving/day in the group C, P = 0.035). Conclusions: The findings found improvement in intervention group A with intake of vegetables and yoghurt as dairy sources compared to Group B. In addition, their mean differences of dairy source was higher than Group C, while serving of fat sources was lower in both groups compared to the control group.
Research articles
Mohammad Kazem Sabzehei; Behnaz Basiri; Maryam Shokouhi; Afshin Fayyazi; Fatemeh Eghbalian
Volume 20, s1 , December 2018, Pages 1-5
Abstract
Background: Transient tachypnea of the newborn (TTN) is one of the important causes of neonatal respiratory distress and hospitalization in the neonatal intensive care unit (NICU). Objectives: The current study aimed at identifying the risk factors of TTN in a single tertiary care center. Methods: The ...
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Background: Transient tachypnea of the newborn (TTN) is one of the important causes of neonatal respiratory distress and hospitalization in the neonatal intensive care unit (NICU). Objectives: The current study aimed at identifying the risk factors of TTN in a single tertiary care center. Methods: The current prospective, case-control study was conducted on 180 newborns allocated in the 2 groups of with TTN (n = 90) as the case group, and without TTN (n = 90) as the control group for 1 year from April to March 2015 in a public hospital of Hamadan, Iran. Newborn and mother’s information was extracted from their medical records. Diagnosis of TTN was based on clinical and radiological findings, after ruling out other respiratory distress causes. Data were analyzed using logistic regression and P < 0.05 was considered the level of significance. Results: The raw data analysis of regression factors associated with TTN showed that the risk of TTN was higher in late preterm infants (odds ratio (OR): 6.15; 95% confi- dence interval (CI): 3.17 - 11.92, P = 0.001) as well as male newborns (OR: 0.33, 95% CI: 0.17 - 0.62, P = 0.001), and those born by cesarean (OR: 11.22, 95% CI: 5.33 - 23.62, P = 0.001). Moreover, the risk of TTN increased with Apgar score in the first minute (OR: 0.02.95% CI: 0.00 - 0.05, P = 0.001) and decreased with the fifth minute (OR: 0.02; 95% CI: 0.00 - 0.06, P = 0.001). The results of multiple regression analysis showed that the odds of TTN of late preterm newborns was 2.96 times higher than that of term newborns(OR: 2.96, 95% CI: 1.09 - 8.04, P = 0.033). Furthermore, with increase in Apgar score in the first minute, the risk of TTN reduced (OR: 0.02; 95% CI: 0.01 - 0.07, P = 0.001). Conclusions: Prematurity and Apgar score in the first minute were the risk factors for TTN. Consequently, the risk of TTN can be reduced by the prevention of preterm birth and improvement of perinatal care.
Research articles
Shirin Ayani; Khadijeh Moulaei; Ashraf Alimadadi; Mahmoud Bakhtiari; Rafat Bayat; Faezeh Sadeghi; Samaneh Nematolahi; Mohammad Shahrabadi
Volume 20, s1 , December 2018, Pages 1-10
Abstract
Background: E-learning is a recent approach in education, commonly appreciated for teaching students in most scientific fields, particularly in the university. However, in medical education, this approach has difficulties that reduce its performance. Through the survey of the present models defining ...
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Background: E-learning is a recent approach in education, commonly appreciated for teaching students in most scientific fields, particularly in the university. However, in medical education, this approach has difficulties that reduce its performance. Through the survey of the present models defining E-learning components, in respect to the patient simulation systems playing an important role in medical education, some deficiencies of these models have been revealed. Objectives: In order to provide appropriate tools and techniques for implementing patient simulation within the learning man- agement system, this research aimed at identifying the deficiencies of E-learning models and proposing a new model. Methods: In this review article, published accredited articles or books were initially searched in order to obtain E-learning compo- nents and different types of patient simulation systems. Through a study of E-learning components in selected models, the short- comings in implementing various kinds of patient simulation systems were determined and the “Parsian” model was subsequently introduced. Results: According to the results of the conducted research, it was found that the group of component tools in E-learning models, which could be classified in 3 different groups, was not adequate for implementing patient simulation. In the “Parsian” model, necessary tools and techniques were introduced in 3 different groups of software, methods, and techniques and medical equipment.All these groups introduced in the “Parsian” model were applicable. Conclusions: In the school of medicine, professors need patient simulation systems to provide students with E-learning. However, at the moment, there is not such patient simulation system in the existing LMS s all over the world. The LMSs are usually designed to teach courses that are mostly theoretical (rather than practical). Implementation of an LMS, exclusively applicable with high competence for teaching in all the realms of medical sciences, is provided by the means of “Parsian” tools and techniques.
Research articles
Hassan Khazraee; Abdollah Omidi; Reza Daneshvar Kakhki; Zahra Zanjani; Mojtaba Sehat
Volume 20, s1 , December 2018, Pages 1-10
Abstract
Background: Chronic daily headache is a serious disease, causing significant problems such as disability. It is characterized by pain localized to the head (headache) and headaches occurring on 15 or more days per month for more than ...
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Background: Chronic daily headache is a serious disease, causing significant problems such as disability. It is characterized by pain localized to the head (headache) and headaches occurring on 15 or more days per month for more than 3 months (> 180 days per year). Programs for pain and health improvement in patients with painful diseases, such as headache, are not still fully developed. Acceptance and commitment therapy (ACT) is a new psychotherapy, which appears to be effective in the treatment of chronic pain. Objectives: This study aimed to examine the effectiveness of ACT in cognitive emotion regulation strategies, headache-related dis- ability, and headache intensity in patients with chronic daily headaches. Methods: In the current study, a semi-experimental method was applied. The study was conducted at Shahid Beheshti Govern- mental hospital of Kashan, Iran in 2016. The sample consisted of 40 patients with chronic daily headache, who were selected via convenience sampling. The participants were randomly allocated into medical treatment as usual (MTAU) and ACT groups (20 sam- ples per group) via block randomization. The ACT group received eight 90-minute weekly treatments, based on the ACT protocol. The cognitive emotion regulation questionnaire (CERQ), diary of headache severity, and headache-related disability inventory (HDI) were administered at pretreatment, posttreatment, and three-month follow-up in both groups. Results: In the current study, no significant differences were found between the groups in terms of demographic variables (P > 0.05). In the ACT group, the mean (SD) scores of emotional and functional aspects of headache disability were 26.87 ± 10.11 and 28.50 ± 9.04, respectively before the intervention, which decreased to 17.75 ± 8.32 and 18.12 ± 9.42 after the intervention and 21.37 ± 8.53 and 21.37 ± 9.87 in the follow-up, respectively (P < 0.05). In addition, the mean (SD) score of nonadjustment cognitive emotion regulation strategies was 54.31 ± 10.02 at pretreatment, which significantly reduced to 44.43 ± 7.7 at posttreatment and 49.78 ± 9.1 in the follow-up (P < 0.05). Furthermore, the mean (SD) score of adjustment cognitive emotion regulation strategies was 61.43±12.02 in the pretest, which significantly increased to 72.06 ± 8.66 in the posttest and 69.62 ± 11.84 in the follow-up (P < 0.05). The mean score of headache intensity decreased from 6.40 ± 1.19 to 5.00 ± 1.09, compared to the pretest (P < 0.05); however, there was no significant difference between the groups in the follow-up (P > 0.05). Conclusions: The results of the present study suggested that ACT is an effective treatment for reducing nonadjustment cognitive emotion regulation strategies, headache-related disability, and headache intensity and improving adjustment emotion regulation strategies in patients with chronic daily headache.
Research articles
Hamid Ravaghi; Morteza Salemi; Masoud Behzadifar; Masood Taheri Mirghaed; Meysam Behzadifa; Zeynab Farhadi
Volume 20, s1 , December 2018, Pages 1-11
Abstract
Context: The emergency department is the first place in the hospital that patients will be referred to receive services. Patients often experience an emergency referral in their lives. Emergency care and paraclinical services are provided to patients in this depart- ment. The current study aimed at evaluating ...
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Context: The emergency department is the first place in the hospital that patients will be referred to receive services. Patients often experience an emergency referral in their lives. Emergency care and paraclinical services are provided to patients in this depart- ment. The current study aimed at evaluating the patients’ satisfaction with the emergency departments in Iran through a system- atic review and meta-analysis. Evidence Acquisition: The databases including Web of Science (WOS), Embase, PubMed, Scopus, Ovid, as well as the Iranian databases such as Irandoc and Magiran in the Persian and English languages were searched from 2000 to 2017. The STROBE (strength- ening the reporting of observational studies in epidemiology) checklist was used to assess the quality of the research methodolo-gies. The random model was used to determine the mean value of satisfaction, and the results were reported with the confidence interval (CI) of 95%. Also, sensitivity analysis, subgroup, and meta-regression were conducted. The Egger test was used to investigate the publication bias in the studies. Results: Based on the random model, the mean of satisfaction with emergency services in Iran was 70.52% (95% CI: 63.81 - 77.23). The results of the sensitivity analysis showed no change before and after the analysis of the results. Highest and lowest rates of patient satisfaction were reported in the Eastern (79.17%) and Northern regions (67.15%) of Iran, respectively. Conclusions: The current study findings showed that patients’ satisfaction with emergency services in Iran was high compared with the neighboring countries. Health policymakers should increase patients’ satisfaction through appropriate training, infor- mation, and increased human resources.
Research articles
Adeleh Sadeghloo; Mohammad Reza Sheikhi; Isa Mohammadi Zeidi; Mahmoud Alipour Heydari; Mohammad Ebrahim Sarchloo
Volume 20, s1 , December 2018, Pages 1-7
Abstract
Background: Taking care of veterans with Post-Traumatic Stress Disorder (PTSD) is associated with negative impacts on the quality of life and lifestyle of the caregivers, especially the spouses. Objectives: The current study aimed at evaluating the effect of a health promotion lifestyle training program ...
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Background: Taking care of veterans with Post-Traumatic Stress Disorder (PTSD) is associated with negative impacts on the quality of life and lifestyle of the caregivers, especially the spouses. Objectives: The current study aimed at evaluating the effect of a health promotion lifestyle training program on the spouses of veterans with PTSD in Gorgan city, Iran.Patients and Methods: A total of 63 spouses of Iranian veterans with PTSD covered by the Foundation of Martyrs and Veterans Affairs in Gorgan were enrolled in this quasi-experimental study by the target-based sampling method. Subjects were assigned to 2 groups of experimental (n = 30) and control (n = 33). Eight 45- to 60-minute sessions of educational training were held for the experimental group within 8 weeks. Demographic data checklist and the Health Promoting Lifestyle Profile (HPLP) questionnaire were employed to collect data. Results: The mean total scores of health promotion lifestyle and subscales of physical activity, stress management, health care responsibility, and spiritual development significantly increased in the experimental group after the intervention (P < 0.05). The total score of health promotion lifestyle in the experimental group increased from 112.93 ± 20.63 to 122.52 ± 19.36, while the totalscore of health promotion lifestyle in the control group changed from 112.25 ± 26/09 to 110.27 ± 24.83. However, changes in the subscales of nutrition and interpersonal relationships were insignificant (P > 0.05).Conclusion: According to the results of the current study, educational interventions significantly improved lifestyle and health promotion behaviors in the spouses of veterans with PTSD. Hence, it is recommended to emphasize on training interventions as part of health promotion programs and improvement of lifestyle in care givers.
Research articles
Soroush Aalipour; Sedigheh Hantoushzadeh; Mamak Shariat; Sadaf Sahraian; Mahdi Sheikh
Volume 20, s1 , December 2018, Pages 1-6
Abstract
Background: Umbilical cord blood (UCB) gas analysis is recommended in high-risk pregnancies. However, in chronic medical conditions, cord blood acidosis might not indicate acute fetal stress, rather it might be due to fetal adaptation to the chronic stress. Objectives: Evaluating the association between ...
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Background: Umbilical cord blood (UCB) gas analysis is recommended in high-risk pregnancies. However, in chronic medical conditions, cord blood acidosis might not indicate acute fetal stress, rather it might be due to fetal adaptation to the chronic stress. Objectives: Evaluating the association between UCB acidosis with maternal factors and adverse neonatal outcomes in term preg- nancies with gestational diabetes mellitus. Methods: This prospective cohort evaluated 673 pregnant women who had term pregnancies and were admitted for elective ce- sarean delivery. A total of 80 women had gestational diabetes. After delivery, a blood sample was obtained from the umbilical artery for arterial blood gas analysis. The neonates were then followed. Results: Term pregnancies with gestational diabetes had significantly higher UCB acidosis rates compared to the healthy controls (26.2% vs. 6%, P < 0.001). In mothers with gestational diabetes, UCB acidosis was independently associated with higher maternal body mass index (P = 0.04) and HbA1C levels (P = 0.01). In the term neonates born to gestational diabetes mothers, after adjustment for gestational age, birth weight and pre-delivery blood glucose, UCB acidosis remained significantly associated with macrosomia (47.6% vs. 23.7%, P = 0.04), neonatal hypoglycemia (76.1% vs. 25.4%, P = 0.002), and moderate-severe jaundice (71.4% vs. 27.1%, p0.01). Conclusions: In our study term, pregnancies with gestational diabetes had a higher rate of UCB acidosis, which was associated with poor maternal glycemic and weight control during the last gestational trimester. UCB acidosis in these pregnancies seems to be independently associated with adverse neonatal outcomes.
Case reports
Ali Mirmansouri; Farnoush Farzi; Abbas Sedighinejad; Bahram Naderi Nabi; Gelareh Biazar
Volume 20, s1 , December 2018, Pages 1-4
Abstract
Introduction: Diffuse-type gastric carcinoma with signet ring cells (SRC) is a poor-prognosis subtype of gastric cancer, highly ma- lignant with stromal induction .Till now searching for molecularly targeted drugs for these cases is disappointing. Case Presentation: A 59-year-old female diagnosed with ...
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Introduction: Diffuse-type gastric carcinoma with signet ring cells (SRC) is a poor-prognosis subtype of gastric cancer, highly ma- lignant with stromal induction .Till now searching for molecularly targeted drugs for these cases is disappointing. Case Presentation: A 59-year-old female diagnosed with gastric cancer was admitted to Aria Hospital in Rasht, Iran in 2011. She underwent a subtotal gastrostomy as complete tumor resection with free surgical margins and adequate lymph node dissection. Diffuse infiltrating carcinoma was poorly differentiated. SRC carcinoma, tumor invades at the serosal surface, vascular and per- ineurial invasion, but no regional lymph node metastasis was reported. Then, the patient received chemotherapy with Taxotere plus oxaliplatine and 5-fluorouracil (5 FU) for 6 cycles and 20 sessions of radiation. At present, 6 years after the initial surgery, the patient is alive without any recurrence. Conclusions: In the current case report the vital role of a multi-disciplinary approach to save cancer patients’ lives is strongly appreciated.
Research articles
Hamideh Lari; Azita Noroozi; Rahim Tahmasebi
Volume 20, s1 , December 2018, Pages 1-8
Abstract
Background: Physical activity is a vital element in diabetic patients and training of this behavior is important. Therefore, the present study aims to compare the effect of multimedia and short message service (SMS) based on the health promotion model on the physical activity of patients with Type 2 ...
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Background: Physical activity is a vital element in diabetic patients and training of this behavior is important. Therefore, the present study aims to compare the effect of multimedia and short message service (SMS) based on the health promotion model on the physical activity of patients with Type 2 diabetes. Methods: In this clinical trial study, 37 subjects in the SMS group and 40 subjects in the multimedia group were studied. Subjects in the SMS group received training messages based on the health promotion model for 2 weeks, and the subjects of multimedia groupreceived a teaching CD based on the health promotion model. Both groups completed the questionnaires at the beginning of the study, 2 weeks after training and 3 months after the 2nd stage. Results: The participants in the 2 groups were similar in terms of demographic variables. The comparison of the 2 groups showed that there was a significant difference between 2 groups in terms of the perceived self - efficacy (p = 0.032), benefits (p < 0.001), family (p = 0.024), and friend support (p = 0.002), however, the perceived health status (p = 0.271) and barriers (p = 0.085) had no statistically significant difference between 2 groups during the study. Additionally, 3 months after the education, the mean metabolic equivalent of task (MET) increased to 2634.71 ± 502.01 and 2614.03 ± 592.45 in SMS and multimedia groups respectively; there was no significant difference between the 2 groups (P = 0.662). Conclusions: The results of this study showed more usefulness of multimedia rather than SMS education in changing the belief of diabetic patients about the physical activity and also the effectiveness of both educational methods for promoting physical activity of diabetic patients.
Research articles
Ahmad Osta; Parvaneh Vasli; Meimanat Hosseini; Malihe Nasiri; Camelia Rohani
Volume 20, s1 , December 2018, Pages 1-8
Abstract
Background: Operating room staffs are constantly subjected to a wide range of risks and injuries; therefore, any attempt to increase their safety through education is justified and considered a necessity. Objectives: The aim of present study was to determine the effect of education based on the health ...
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Background: Operating room staffs are constantly subjected to a wide range of risks and injuries; therefore, any attempt to increase their safety through education is justified and considered a necessity. Objectives: The aim of present study was to determine the effect of education based on the health belief model on adherence to standard precautions in operating room staff. Materials and Methods: This single-arm clinical study was carried out with a single-group, before-after study design. Seventy eli- gible operating room staff members from a hospital in Islamabad-e-Gharb, a city in Iran, were selected using the census sampling method in 2016 - 2017. The educational program, based on the constructs of the health belief model and related to taking standard precautions, was completed by operating room staff in three separate 30 to 45-minute sessions. Data collection tools included a demographic questionnaire and six researcher-created questionnaires based on the health belief model constructs and a standard self-efficacy questionnaire. The validity and reliability of all questionnaires were assessed and verified. Data were collected and an- alyzed before and 4 weeks after the educational program. Both the descriptive and inferential statistics (paired t-test) functions ofSPSS version 22 were used to analyze the data. Results: Nearly 85.7% of the operating room staff participants were men, and their mean age was 37.30 ± 6 years. The means and standard deviations of adherence to the standard precautions before and after the education were 35.17 ± 5.65 and 37.71 ± 5.83, respectively. The results of the paired t-test showed that except in case of cues to action, education based on the health belief model brought about significant changes in the constructs of this model, including perceived susceptibility (p = 0.03), perceived severity (P = 0.01), perceived benefits (P = 0.04), perceived barriers (P = 0.01), self-efficacy (P = 0.03), and adherence to standard precautions (P = 0.04). Conclusions: Nursing managers, nurses, and operating room staff can use the findings of this study for education and assessment of adherence to standard precautions.
Research articles
Gholam Ali Heidari; Sedigheh Sadat Tavafian
Volume 20, s1 , December 2018, Pages 1-7
Abstract
Background: False beliefs and fear of movement are common among patients with chronic low back pain (CLBP).Objectives: The current study aimed at changing the relaxation behaviors (RB) of patients with chronic low back pain based on educational programs through the Theory of Reasoned Action. Methods: ...
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Background: False beliefs and fear of movement are common among patients with chronic low back pain (CLBP).Objectives: The current study aimed at changing the relaxation behaviors (RB) of patients with chronic low back pain based on educational programs through the Theory of Reasoned Action. Methods: The current experimental study was conducted from May to Nov 2016 on patients with chronic low back pain referred to pain clinics in Yazd, Iran. Through random blocking of every two participants, two groups were formed; the intervention (N = 43) group received educational programs based on the theory of reasoned action plus physician visits, and the control group (N = 45)received just physician visits. Results: The mean age of intervention and control groups was 40.14 ± 6.8 and 38.33 ± 5.46 years, respectively. The mean score of RB in the intervention group improved from 4.58 ± 1.73 at baseline to 4.51 ± 1.69 and 3.02 ± 1.64 at three- and six-month follow-up times, while in the control group the changes were from 2.84 ± 1.62 at baseline to 3.49 ± 1.16 and 3.20 ± 1.42 at the same follow-up times; the changes were significant (P = 0.04). Conclusions: The educational programs of the current study could be recommended to change the beliefs of patients with chronic low back pain about the relaxation behaviors.
Research articles
Roghayeh Mohammadierad; Sakineh Mohammad-Alizadeh-Charandabi; Mojgan Mirghafourvand; Fariba Fazil
Volume 20, s1 , December 2018, Pages 1-9
Abstract
Background: Reduction of pain and anxiety during labor is necessary to prevent some of the maternal and fetal complications, as well as request for cesarean section. There is limited evidence assessing the effects of saffron and dates on the intensity of pain and anxiety. Objectives: The current study ...
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Background: Reduction of pain and anxiety during labor is necessary to prevent some of the maternal and fetal complications, as well as request for cesarean section. There is limited evidence assessing the effects of saffron and dates on the intensity of pain and anxiety. Objectives: The current study aimed at examining the effect of saffron with or without dates on the intensity of pain and anxiety during transitional and active phases of labor in primiparous females.Methods: In the current superiority trial, 96 primiparous females admitted to a hospital covered by the Iranian social security organization in Tabriz, Iran, at the onset of the active phase of labor were recruited using convenience sampling method from 10 January to 21 October 2016. They were randomly divided into three equal groups using block randomization; receiving 80 mL oral syrup of saffron (250 mg) plus date juice (65 g), saffron (250 mg) plus artificial sugar (165 mg sodium saccharin and 420 mg sodium carboxymethyl cellulose), or placebo every two hours for maximum three doses (240 mL). The intensity of pain and anxiety were assessed using 0-10 visual analogue scale every one hour.Results: Compared with the placebo, mean scores of both pain and anxiety were lower in the intervention groups. The differences were statistically significant at the saffron plus date juice group (adjusted mean difference: -0.8 (95% confidence interval (CI): -1.5 to 0.0), P = 0.022 and -1.3 (95% CI: -2.4 to -0.2), P = 0.012, respectively), but were not significant at the saffron plus artificial sugar group (-0.5 (95% CI: -1.2 to 0.2), P = 0.322 and -1.1 (95% CI: -2.2 to 0.0), P = 0.058, respectively). The differences between the two interven- tion groups were not statistically significant (-0.3 (95% CI: -1.0 to 0.4), P = 0.557 and -0.2 (95% CI: -1.3 to 0.8), P = 0.927, respectively). One woman from saffron plus date juice, three from saffron plus artificial sugar, and four from the placebo groups had emergency cesarean section. Conclusions: The current study results show that the oral syrup of saffron plus date juice could be used to reduce the intensity of pain and anxiety during labor in primiparous females. However, the results are inconclusive for the effects of saffron plus artificial sugar.
Case reports
Pan Chao- wen; Hsiu- Lung Fan; Chen Ya-Cheng; Guo-Shiou Liao; Mong Fan- Yun; Min-Jen Tsao
Volume 20, s1 , December 2018, Pages 1-4
Abstract
Introduction: The incidence of splenic cysts is low, and most are asymptomatic. Symptomatic splenic cysts have rarely been re- ported. Due to the unspecific clinical and radiologic features, the nature of a cyst is difficult to define in the absence of a history of trauma. Therefore, splenectomy is usually ...
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Introduction: The incidence of splenic cysts is low, and most are asymptomatic. Symptomatic splenic cysts have rarely been re- ported. Due to the unspecific clinical and radiologic features, the nature of a cyst is difficult to define in the absence of a history of trauma. Therefore, splenectomy is usually the treatment of choice for obtaining a specimen. In particular, total splenectomy has been the treatment of choice for removal of splenic cysts. Case Presentation: A 25-year-old male patient visited the outpatient department at Tri-Service General Hospital Penghu Branch,Taiwan, with the chief complaint of abdominal fullness. No obvious history of trauma was reported. A series of examinations were performed, and abdominal computed tomography showed one large splenic cyst within the splenic septum. We performed single- incision laparoscopic splenectomy, and the patient recovered well and returned to daily activities one week later. Conclusions: In this modern era of minimally invasive surgery, laparoscopic surgery has reduced postoperative pain and improved recovery, with no increase in complications. Laparoscopic splenectomy has become the trend for the management of splenic cysts. Although single-incision laparoscopic surgery is a technical challenge, better cosmetic results and decreased postoperative wound pain are considered to be superior outcomes compared with those of conventional multi-port laparoscopic surgery.
Research articles
Mansooreh Aliasgharpour; Fahimeh Davodabady; Mahbobeh Sajadi; Shadan Pedram Razi; Anoshiravan Kazem-nejad
Volume 20, s1 , December 2018, Pages 1-7
Abstract
Background: Pain is the most common and frustrating symptom of cancer. Despite the availability of different guidelines for its management, controlling pain is still not possible. Objectives: The current study aimed at evaluating the effect of pain management education on the severity of pain in patients ...
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Background: Pain is the most common and frustrating symptom of cancer. Despite the availability of different guidelines for its management, controlling pain is still not possible. Objectives: The current study aimed at evaluating the effect of pain management education on the severity of pain in patients with cancer. Methods: The current clinical trial (IRCT201403122226N14) was conducted during the year 2014, in association with two hospitals affiliated to Arak University of Medical Sciences in Iran. In this study, 98 patients with cancer were designated to either the interven-tion or control group. The intervention included six educational sessions and a training manual. The severity of pain in patients was assessed prior to the intervention, and at three and six weeks after the intervention. Results: Data showed that 55.1% of the patients were male and 65.3% were married. The majority (33.67%) were aged 18 to 30 yearsold. At the beginning of the study, the study population was homogenous for the demographic variables and severity of pain (P = 0.871). The mean (SD) score of pain severity in the intervention group before, at three, and six weeks after the intervention was 30.18 (8.18), 17.46.18 (11.10), and 16.51 (10.83), respectively (P < 0.001). The mean (SD) score of pain severity in the control group before, at three, and six weeks after the intervention was 30.44 (8.007), and 75.7 (10.9), 30.08 (8.37) and 29.95(8.49) respectively (P = 0.955). After the intervention, a significant difference was observed in the severity of pain between the groups (P < 0.001). Conclusions: The results showed that pain management training could reduce the severity of pain in patients with cancer. There- fore pain management training could be designed for patients with cancer in order to promote their quality of life.
Research articles
Mohammad Jafari Sirizi; Mohammad Reza Shakibi; Mehdi Shafie; Seddighe Mohammad-Taghizadeh; Mohsen Barouni; Nouzar Nakhaee
Volume 20, s1 , December 2018, Pages 1-6
Abstract
Background: Adherence to screening services is a prerequisite for the success of screening programs.Objectives: This study aimed at determining factors associated with participants’ compliance with Dual-energy X-ray Absorptiom- etry (DXA) screening for osteoporosis. Methods: In this population-based ...
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Background: Adherence to screening services is a prerequisite for the success of screening programs.Objectives: This study aimed at determining factors associated with participants’ compliance with Dual-energy X-ray Absorptiom- etry (DXA) screening for osteoporosis. Methods: In this population-based participatory study, 1000 males and females older than 55 years old were invited to participate in the study. The study took place in the city of Kerman, Iran, where subjects were informed face to face about the risk factors and complications of osteoporosis and asked to complete a questionnaire. The subjects were then invited to visit a densitometry centerfor a free DXA study. Four rural areas and 4 locations in Kerman were selected based on municipal divisions.Results: A total of 923 individuals completed the questionnaire: 562 (60.9%) were female, nearly two-thirds were from urban areas, and 284 (30.8%) were willing to undergo densitometry. Eight percent had a history of corticosteroid use for more than 3 months. About two-thirds of the participants were walking less than 150 minutes per week. In the logistic regression analysis, urban residents (OR = 1.88), females (OR = 1.52), and those who perceived high risk of osteoporosis (OR = 1.67) were more likely to adhere to DXA screening. Conclusions: On the whole, despite informing people about osteoporosis and offering free services, compliance to densitometry was not remarkable.
Research articles
Vegar Kazempour; Hossein Ebrahimi; Mohammad Asghari Jafarabadi; Seyyed Gholamreza Nourazar; Hamideh Zamani
Volume 20, s1 , December 2018, Pages 1-10
Abstract
Background and Objectives: Bipolar disorder (BD) is defined as emotion dysregulation. Since such dysregulation is also present during remission, it may be a risk factor for the development of further affective episodes. Therefore, the current study aimed at examining the impact of group cognitive behavioral ...
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Background and Objectives: Bipolar disorder (BD) is defined as emotion dysregulation. Since such dysregulation is also present during remission, it may be a risk factor for the development of further affective episodes. Therefore, the current study aimed at examining the impact of group cognitive behavioral therapy (GCBT), in comparison to treatment as usual (TAU), on the cognitive emotion regulation strategies of patients with BD. Patients and Methods: The current single-blind, randomized controlled trial (RCT) was performed from 2015 to 2017 in the psychi- atric clinic of a referral hospital affiliated to Tabriz University of Medical Sciences, Tabriz, Iran. A total of 70 adolescents with early- onset BD were selected by the convenience sampling method based on the diagnostic and statistical manual of mental disorders- fourth edition-text revision (DSM-IV-TR) and allocated into receive either 12 sessions of GCBT (N = 35) or TAU (N = 35). Cognitiveemotion regulation strategies were evaluated by cognitive emotion regulation questionnaire (CERQ) at baseline, after the interven- tion, and at 3-month follow-up. Efforts were made to follow up all randomized participants even if they withdrew from the assigned treatment prior to completion of GCBT sessions. Results: Compliance with treatment was moderate and the mean number of GCBT sessions that the participants attended was 6.97 (2.81). The two groups had significant differences in terms of post-test scores for other-blame (P = 0.001), rumination (P = 0.049),positive refocus (P = 0.008), positive reappraisal (P = 0.005), and putting into perspective (P = 0.001). In the 3-month follow-up, the two groups were significantly different only in other-blame (P = 0.001), positive reappraisal (P = 0.001), and putting into perspective subscales (P = 0.001). Therefore, the effects of the intervention were not effectively sustained after three months and there was room for improvement in terms of both outcome and compliance. Conclusions: The GCBT is more effective when the participants are involved in the study and get instructions on emotion regulation. However, since the effects of the intervention were not sustained for most of the subscales after three months, booster sessions might improve and prolong the impact of psychotherapies.
Research articles
Reza Jorvand; Mahmoud Tavousi; Fazlollah Ghofranipour
Volume 20, s1 , December 2018, Pages 1-9
Abstract
Background: Inactivity is one of the factors to increase the risk of having cardiovascular diseases. Objectives: This methodological design study was conducted on the staff of Ilam Medical Science University (Ilam, Iran) in 2016 in order to assess the psychometric properties of the Iranian version of ...
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Background: Inactivity is one of the factors to increase the risk of having cardiovascular diseases. Objectives: This methodological design study was conducted on the staff of Ilam Medical Science University (Ilam, Iran) in 2016 in order to assess the psychometric properties of the Iranian version of Impact of Sport on the Cardiovascular Diseases Scale based on the Health Belief Model (HBM - ISCS). Methods: In this study, first, targeted questions were selected based on the scientific literature review (N = 54) and then, the basic version of the questionnaire, including 14 questions in terms of HBM (Health Belief Model) constructs, went on the validation phase using the opinions of experts. At this stage, content and construct validity and reliability were reviewed and approved. Results: Over all, 433 individuals with a mean age of about 38 years participated in the study. Based on the results, content validity rate (CVR) higher than 0.05 (number of specialists = 20) and content validity index (CVI) higher than the acceptable level of 0.79 were calculated. The primary Exploratory Factor Analysis (in a random spitted sample, N = 187) extracted five factors that jointly accounted for 59.804% of the variance observed. The results of Confirmatory Factor Analysis (in a random spitted sample, N = 246) showed that the questionnaire has desirable construct validity: (X2 = 146.81, df = 67, P < 0.001, CFI = 0.93, IFI = 0.93, RMSEA = 0.074 and SRMR = 0.067). Similarly, the Cronbach’s alpha coefficient was calculated between 0.715 and 0.816, and the Intraclass Correlation Coefficient (ICC) was obtained between 0.455 and 0.623 for the subscales. Conclusions: The results indicated that HBM - ISCS is a valid and reliable tool for measuring the health beliefs about the impact of sport on CVDs prevention.
Research articles
Fariba Shahraki-Sanavi; Alireza Ansari-Moghaddam; Fatemeh Rakhshani; Mahdi Mohammadi
Volume 20, s1 , December 2018, Pages 1-7
Abstract
Background: Improving and providing community health is one of the main pillars of community development.Objectives: The present study aimed at investigating the effect of school-based interventions on health-risk behaviors among ado- lescents in the South-East of Iran. Methods: This interventional quasi-experimental ...
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Background: Improving and providing community health is one of the main pillars of community development.Objectives: The present study aimed at investigating the effect of school-based interventions on health-risk behaviors among ado- lescents in the South-East of Iran. Methods: This interventional quasi-experimental study recruited a total of 420 adolescent females in the 10th grade of public schools, selected by the census in Zahedan, Iran. The study tool was a questionnaire of high-risk health behaviors with a Content Validity Ratio (CVR) of 0.80, a Content Validity Index (CVI) of 0.88, and reliability (α) of 0.70. After the pre-test, multidimensional in- terventions (individual education, group education, individual counseling, modern education, and parents’ educational packages) were provided for the intervention group from October 2015 to June 2016. After a three-month interval, the post-test was conducted during October 2016.Results: The mean score changes in interventional and control group were -0.7 (2.3) and 0.1 (2.7) for high-risk behaviors; 0.8 (5.5) and -0.4 (5.2) for healthy nutritional behaviors, and physical activity behaviors with 1.4 (4.5) and 0.3 (5.1). Also, there was a positive significant relationship between score changes of high-risk behaviors (P < 0.001), healthy nutritional behaviors, and physical ac- tivity (P < 0.05) of students with study group (interventional and control) in univariate linear regression, yet in the multivariate linear model, only high-risk behaviors remained (P < 0.001). Furthermore, after the intervention, three simultaneous behaviors de- creased among the students in the intervention group by 8.4% compared to 1.6% in the control group. The individual consultations among adolescents, who smoked cigarettes or hookahs, drank alcohol, abused drugs or had unprotected sex resulted in high-risk behaviors. Conclusions: To sum up, school-based interventions can improve health behaviors if they target multiple environmental and be- havioral dimensions with a complementary strategy in the target society. Therefore, it is recommended for interventions to be designed and tailored to the needs of students and employed continuously to maintain the effect of education.
Research articles
Elham Eslami; Sakineh Mohammad Alizadeh Charandabi; Azizeh Farshbaf Khalili; Mohammad Asghari Jafarabadi; Mojgan Mirghafourvand
Volume 20, s1 , December 2018, Pages 1-8
Abstract
Background: Obese and overweight females require proper programs for moderating and regulating their weight gain during pregnancy and preventing gestational diabetes. Objectives: This study aimed to determine the effect of a lifestyle-based training package on weight gain and frequency of gesta- tional ...
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Background: Obese and overweight females require proper programs for moderating and regulating their weight gain during pregnancy and preventing gestational diabetes. Objectives: This study aimed to determine the effect of a lifestyle-based training package on weight gain and frequency of gesta- tional diabetes in obese and overweight pregnant females. Methods: This randomized controlled trial was conducted on 140 obese and overweight pregnant females in Tehran, Iran. The training program administered to the intervention group consisted of a 60- to 90-minute session of group training using lectures, booklets, and text messages. A 2-hour 75 g oral glucose tolerance test (OGTT) was performed to screen for gestational diabetes at 24 to 28 weeks of gestation, and gestational diabetes was diagnosed based on the obtained results. The weight increase was calculated 8 weeks after the intervention compared to the beginning of the study. Results: The test results of fasting blood sugar (FBS) and glucose tolerance test (GTT) showed 15 cases of gestational diabetes in the intervention group and 17 in the controls after the intervention, suggesting no statistically significant differences between the 2 groups (P = 0.687). Moreover, based on analysis of covariance (ANCOVA) and with adjusting the baseline values, the mean weight gain was found to be 3.4 kg in the intervention group and 3.8 kg in the control group, suggesting no statistically significant differences between the 2 groups after the intervention (P = 0.634). Conclusions: Although the frequency of gestational diabetes was found to be higher in the intervention group than in the con- trols, the difference was insignificant possibly due to use of a small sample size. Further studies are therefore recommended to be conducted using larger sample sizes.
Research articles
Zahra Asad; Hossein Akbari; Alireza Dehdashti; Milad Motalebi Kashani; Hamidreza Saberi; Masoud Motalebi Kashani
Volume 20, s1 , December 2018, Pages 1-7
Abstract
Background: Traumatic injuries are a leading cause of death and disability in the working population, worldwide. According to estimates, by 2020, traumatic injuries will be the second cause of disability in developing countries and the third cause of death and disability across nations, worldwide. Objectives: ...
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Background: Traumatic injuries are a leading cause of death and disability in the working population, worldwide. According to estimates, by 2020, traumatic injuries will be the second cause of disability in developing countries and the third cause of death and disability across nations, worldwide. Objectives: This study aimed at assessing work-related traumas and related risk factors that may contribute to the development of injuries among Iranian metal melting workers in Kashan industrial sites. Methods: Data were collected by a descriptive cross-sectional study on 178 Iranian metal melting workers in five manufacturing sites of Kashan, selected as a census. The data consisted of a three-year period from 2014 to 2016. Samples were selected as the census. The study used a demographic questionnaire, accident investigation reports, and interviews with workers that had experienced traumatic injuries, to collect data. Results: Overall, 58.43% of workers experienced traumatic events. The data indicated a significant association between ages, years of employment, and being a witness of an accident with work-related trauma (P < 0.05). Workers involved in smelting operations experienced more injuries than workers at other processing units. Most Injuries affected hands and wrists. The leading causes of work-related injuries were contacting with hot objects (42.3%), fall from height (26.9%), electrical shock (1.9%), strike (18.3%), stuck (3.8%), and strain (1.9%). Conclusions: These results may contribute to the nature of tasks in metal melting process, requiring the performance of hot pro- cesses and heavy manual tasks with hand tools. The results provide steps for developing prevention strategies. Metal workers in- volved in performing hot processes and heavy manual tasks might be considered as first targets for preventive interventions.
Research articles
Mojgan Karbakhsh; Shokouh- Alsadat Banijamali; Morvarid Ahadi
Volume 20, s1 , December 2018, Pages 1-6
Abstract
Background: Physicians experience a significant amount of stress. Medical residents and physicians are considered a high-risk group because of long working hours and high levels of stress associated with their training and life.Objectives: This study aimed to evaluate hardiness in physicians according ...
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Background: Physicians experience a significant amount of stress. Medical residents and physicians are considered a high-risk group because of long working hours and high levels of stress associated with their training and life.Objectives: This study aimed to evaluate hardiness in physicians according to specialty, sex, age, and marital status and investigate the relationship between hardiness and aggression, interpersonal sensitivity, and educational success.Methods: In a cross- sectional study, 194 second-year residents from Tehran University of Medical Sciences, Iran, who were studying in 23 different specialties in the year 2017, were enrolled. The data collection tools included a demographic form, hardiness scale, and aggression and interpersonal sensitivity scales of The Symptom Checklist-90-R (SCL90). Results: Mean scores of commitment, challenge, and control were 71.91 ± 15.57, 48.23 ± 13.30, and 71.66 ± 12.98, respectively. Women had significantly lower challenge scores than men (P = 0.017), and the mean challenge score was significantly higher among married participants (P = 0.008). Commitment and control scores were not influenced by the subject’s characteristics (P > 0.05). Increment of grade point average (OR = 0.50, 95% CI 0.29 - 0.87) and control score (OR = 0.96, 95% CI 0.93 - 0.99) significantly decreased the risk of deterioration of aggressive behaviour. Interpersonal sensitivity level was significantly associated with the challenge (P = 0.001), control, and commitment (P < 0.001). Conclusions: Neurosurgeons, psychiatrists, and emergency medicine specialists obtained the highest scores in hardiness, while ra- diotherapists and gynaecologists scored highest in aggression and interpersonal sensitivity. Considering the reverse relationship of hardiness with aggression and interpersonal sensitivity, it is necessary to implement educational programs for boosting hardiness among physicians.
Research articles
Alireza Irajpour; Maryam Sadat Hashemi; Parvaneh Abazari; Shahrazad Shahidi; Maryam Fayazi
Volume 20, s1 , December 2018, Pages 1-9
Abstract
Background: Depression, anxiety, and stress are the most prevalent psychological disorders among patients with chronic renal fail- ure. These disorders increase mortality rate, impair immune function, reduce treatment adherence and quality of life, and heighten the risks of malnutrition, infection, and ...
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Background: Depression, anxiety, and stress are the most prevalent psychological disorders among patients with chronic renal fail- ure. These disorders increase mortality rate, impair immune function, reduce treatment adherence and quality of life, and heighten the risks of malnutrition, infection, and cardiovascular diseases. One potentially effective strategy for the management of psycho- logical disorders is peer education; however, its effects on patients receiving hemodialysis are still unknown. Objectives: This study was conducted to investigate the effects of peer education on depression, anxiety, and stress among hemodialysis patients. Methods: This was a quasi-experimental study. Patients were randomly recruited and allocated in intervention and control groups. In the intervention group, patients were provided with two 120-minute peer education sessions per week for eight successive weeks- sixteen sessions in total. Patients in the control group solely received routine care services, which included no education by peers. Data were collected before and immediately after the intervention via the 42-item Depression Anxiety Stress Scale. Results: Before the intervention, the groups did not significantly differ from each other, respecting the mean scores of depression, anxiety, and stress (P > 0.05). After the intervention, significant decreases in the mean scores of depression, anxiety, and stress were observed in the intervention group (P < 0.05), while none of the mean scores significantly changed in the control group (P > 0.05). Consequently, posttest mean scores in the intervention group were significantly lower than the control group (P < 0.05). Conclusions: Peer education is effective in significantly alleviating hemodialysis patients’ depression, anxiety, and stress. There- fore, peer education is recommended for alleviating psychological problems among patients receiving hemodialysis.
Research articles
Ali Hesamzadeh; Asghar Dalvandi; Sadat Bagher Maddah; Masoud Fallahi Khoshknab; Fazlollah Ahmadi
Volume 20, s1 , December 2018, Pages 1-9
Abstract
Background: Stroke can be seen as a family matter, and nearly all stroke patients live with their families in their communities. Comprehensive insights into stroke recovery from family caregivers’ point of view are lacking.Objectives: The aim of the present study is to explore and describe family ...
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Background: Stroke can be seen as a family matter, and nearly all stroke patients live with their families in their communities. Comprehensive insights into stroke recovery from family caregivers’ point of view are lacking.Objectives: The aim of the present study is to explore and describe family caregivers’ experiences about the contributing elements of promoting the stroke recovery of older adults in the Iranian context. Methods: A qualitative content analysis approach was conducted. From September 2013 to April 2014, 17 family caregivers from multiple physiotherapy clinics in Sari, Iran, participated in this study. Data were generated through in-depth interviews, and the content analysis method was used to determine themes. Results: The results of data analysis were categorized into three main themes: 1) promoting functional recovery; 2) improving psychological health; and 3) strengthening social roles. The general, overarching theme was promoting positive recovery. Conclusions: The family positively figures in the stroke patient’s recovery. Health practitioners must help the stroke families effec- tively play their critical roles in helping their stroke patients recover.
