Journal of Birjand University of Medical Sciences
Year:2009 | Volume:16 | Issue:1 (38)|Papers Count:15

Background and Aim: In recent years reducing the dietary glycemic index has been proposed as a novel approach to weight-loss and prevention of metabolic diseases (type 2 diabetes and cardiovascular diseases). The aim of the present study was to determine the effect of low-glycemic index diet and Low-fat diet on weight-loss, body mass index, fasting and post-prandial glucose and insulin levels in the obese women.Materials and Methods: In this clinical- trial study 46 obese women aged 18 to 55 years -with BMI³27 who had referred to Motahary clinic in Shiraz, Iran, were randomly divided into two equal groups, each with a specific diet (i.e. low fat and low glycemic index) which continued for a period of six weeks. Body weight, BMI, fasting and post-prandial glucose and insulin level of the patients were measured at the beginning and at the end of the period. The obtained data was analysed by means of SPSS statistical software, sample paired-t and sample independent-t at the significant level P<0.05.Results: Mean age of the subjects was 37.9±7.6 years. The variables under study significantly decreased in both groups six weeks after dietary treatment (P<0.05). Mean insulin level in the low fat diet group statistically decreased compared with low GI group (P=0.02). However, regarding other variables no difference was observed between treatment effects in the two groups.Conclusion: Both diets can equally be effective in weight loss, BMI, and glucose concentration level, Additional studies are required to examine the relationship between low fat, low glycemic diets and insulin level in the obese women.

Background and Aim: Cataract is a major occular disease that causes blindness in many developing countries of the world. Experimental model of cataract is a first necessity to study the preventive factors of cataract progression. Several studies have shown that some glucocorticoides such as Dexamethasone (DEX) can induce cataract. The aim of this study was to form cataract in chick embryo.Materials and Methods: During three consequent stages, 120 fertile eggs were used in this study. In each stage 40 eggs in 4 groups were selected and put them into an incubator. Incubation was carried out at 37.5°C and 68% relative humidity. The day that the eggs were placed in the incubator was termed day 1. The first group received normal saline and the other three groups received 0.01, 0.02, and 0.04 micromole of dexamethasone (DEX) on the 14th, 15th, and 16th day of fertilization respectively. After 48 hours of DEX injection, lenses were removed and their opacity was classified into five stages by stereomicroscope (Olympus SZX) to determine the type of cataract. Microscopic study was done after hematoxylin-eosin staining. Data were collected and put in frequency tables and analyzed by Fisher and Chi Square tests in SPSS software and P<0.05 was taken as the significant level.Results: This study showed that use of 0.02 micromole of DEX on the 15th and 16th days of embryonic period can induce cataract in 95% of lenses. Also, use of 0.04 micromole of this drug on the 15th and 16th days of embryonic period can induce cataract in the 100% and 95% of chick lenses, respectively. Differences between cataract frequency of lenses in the experimental groups and control group were significant (P<0.0000), but there were no significant differences of cataract frequency between the experimental groups.Conclusion: Injection of 0.04 micromole of DEX on the 15th day of fertilization, as a choice dose and timecan induce cataract in chick embryo.

Background and Aim: Undoubtedly proper nourishment has a great role in the prevention of many diseases, especially chronic ones, and also increasing mental and physical efficiency. One of the main factors which ensures appropriate nutrition in families is how much knowledge each member of family has about the principles of right nutrition. Meanwhile, the role of mothers, as diet planners in family nourishment, is crucial. The present study was aimed at assessing nutritional knowledge of high school girls in Ahwaz and education effect on their knowledge.Materials and Methods: The present study was conducted in a semi-experimental intervention on 150 female third-grade high school students in Ahwaz applying randomized cluster sampling. The questionnaire used in this survey contained 30 questions (23 questions about knowledge level and 7 demographic questions).Firstly, the students were given a test (a questionnaire) in their have own schools. Secondly, education was presented in two ways: a. face to face, b. booklets. Finally, the students’ knowledge level was tested once more. The obtained data was analysed by means of SPSS software, paired sample t, correlation coefficient, mean and standard deviation indices at the significant level P<0.05.Results: It was found that mean knowledge score increased from 14.53±2.32 to 18.1±3.03 as a result of education; a growth equal to 15.62 %. Besides, assessment results indicated the growth from 0 to 42.8% in correct answering to various questions (P=0.003); thus, education efficacy was actually significant.Conclusion: This study approves the results of similar research conducted ,in and outside the country ,on various age groups and careers regarding positive effects of education on nutritional knowledge, yet the fact that in what aspects the subjects knowledge needed to be  promoted through education is something not sufficiently taken into consideration in previous studies

Background and Aim: Tuberculosis (TB) covers a wide spectrum of clinical diseases caused by mycobacterium tuberculosis. Each second, one individual is infected with TB; every four seconds one develops it; and every 10 seconds one patient loses his or her life because of the disease. Ten million new cases of TB and 3 million deaths by this infection are reported annually. Regarding the importance of the disease in our country, particularly its high prevalence in the bordering provinces of the country, the present study was designed and carried out to assess the epidemiology of TB in Birjand.Materials and Methods: This research was an analytical and descriptive study covering all patients who had referred to the center of TB control in Birjand during one decade (1996-2006). Data collection was done through a questionnaire aptly designed for the study. The obtained data was analysed by means of SPSS software, statistical tests including X2 and t-test were used at the significant level of P<0.05.Results: Totally, 840 cases were diagnosed; 42.6% of them were males, 96.1% Iranians, and 41% were villagers. Mean age of the patients was 48.9±21.6 years. Prevalence of the disease varied between 14.6% (the least) and 40.6% (the most) per 100000 people .Out of the total cases, %70 (588 patients) were pulmonary tuberculosis and %30 (252) were extrapulmonary; the most common of which were lymph node, spinal column, and pleural TB. Regarding types of the disease 90.5% were new cases, 8% were relapses, 0.6% treatment failure, 0.2% resistant; 83.7% were treated with a 6 month and 16.3% with an 8 month regimen. This research didn't show any significant difference with respect to sex, nationality, and habitation. Mean age of developing the disease in males was significantly higher than females’ (P=0.003). The age of the patients was also significantly higher in extrapulmonary compared to pulmonary TB (P<0.001).Conclusion: Regarding the high prevalence of TB incidence in Birjand it is necessary to follow up case finding, prevention and treatment of TB in the health-care system of the city so that an appropriate condition for the decrease of TB incidence would be provided.

Background and Aim: Women are among the most important foundations of the family and society; and the health of the community depends to a large extent, on meeting the needs of this group. One of the most critical stages of women’s lives is menopause and one of the aims of health for all in the 21st century is the improvement of the quality of life. In menopausal women, the term quality of life incorporates menopausal clinical signs such as hot flushes, night sweats, and vaginal mucosa dryness.Materials and Methods: In this quasi-experimental study, 62 women aged 44-55 years referring to Motahhari clinic in Shiraz were selected through normal sampling, and were randomly divided into two equal case and control groups (31 in each). Data was collected by means of a modified Hildich et al questionnaire on quality of life during menopausal period. Prior to and 3 months after educational intervention (in the form of group discussion), quality of life of the subjects (vasomotor, psychosocial, physical and sexual aspects) were evaluated. The obtained data was analysed using statistical tests including independent T, and Likert transformed technique for grading; and measuring quality of life at the significant level.Results: Prior to education, mean quality of life score in the case and control groups was 81.7±6.4 and74.8±1.8 ; which changed to 75.3±6.7 and 75.8±1.4 respectively, three months after intervention. Statistical tests showed that the test group experienced a significant improvement in their quality of life (P=0.001). Comparison of the quality of life between the two groups before and three months after intervention revealed a significant difference between them (P=0.001).Conclusion: The study showed that four aspects of quality of life significantly changed after education and the complications of menopausal women decreased in severity, which improved their living. Thus, implementing appropriate educational programs to promote the quality of life in menopausal women is necessary.

Background and Aim: Congenital anomalies of spine especially in the lumbosacral region represent an extensive spectrum from simple asymptomatic defect (spina bifida occulta) to complicated myelomeningocele with profound neurogenic deficits. The goal of the present study was to determine neural tube defects (NTDs) frequency in asymptomatic in apparently healthy adults in Birjand.Materials and Methods: The study was a cross-sectional descriptive one on 925 seemingly healthy individuals applying for employment in IRI police force in Birjand city in 2007. Radiographs of lumbosacral region were obtained in the anterior-posterior and lateral projections. Additional views were also acquired if indicated. All radiographs were examined by an experienced radiologist to detect any lumbosacral anomalies. Statistical analysis was well done by SPSS (version 12) at the significant level P<0.05.Results: Mean age of the subjects was 23.6±5.5 years. 76% of the populations were single and 68% of them had been born in South Khorasan province. 21.6% of the subjects had one of NTDs. The most prevalent anomaly was spina bifida (14.7%). The most common involved vertebra was S1 (11.7%) and the second most common anomaly was bilateral or unilateral sacralization of L5 (6%).Conclusion: According to the findings of the study asymptomatic lumbosacral disraphisms in the region are relatively common (21.6%) the most prevalent of which is spina bifida occulta involving S1 vertebra. Regarding the role of nutrition (folic acid) and genetics in the occurrence of these complications, more research on and attention to the diet of pregnant mothers are recommended. Although there are reasons supporting the occurrence of late appearing complications such as chronic and hernidiscal backaches, this congenital complications association requires more research.

Background and Aim: Iron deficiency anemia is the most common nutritional anemia in developed and developing countries. In addition, lead intoxication especially in developing countries is an increasing risk for health; because of rapid urbanization and consumption of leaded fuels. Many studies, particularly on children, have showed a correlation between iron deficiency and increase in blood lead-concentration. In this study, we evaluated this association in workers of a car battery manufacturer.Materials and Methods: This research was performed on workers who were exposed to lead in a car battery manufacturer in Mashhad, Iran, in 2006. Various laboratory tests including complete blood count (CBC), serum ferritin concentration applying radioimmunoassay method and blood lead concentration (BLC) by means of atomic absorption spectrophoyometry (Perkin Elemer, Model 3030) were performed. The obtained data was analyzed by the statistical package for social sciences (SPSS, version 11.5) and statistical tests including t- test and Pearson's correlation coefficient were used. P<0.05 was taken as the significant level.Results: Based on clinical (lead line) and laboratory observations, all workers had lead intoxication with mean BLC of 32.2±13.7 mg/dl. There was not a significant difference between mean BLC in iron-deficient (n=11) and non-iron-deficient workers (n=78). Besides, applying Pearson's correlation coefficient did not reveal any correlation between blood lead with serum ferritin and blood hemoglobin. (r=0.18, P=0.09; and r=0.051, P=0.68 respectively).Conclusion: In this study, no correlation between blood lead concentration with serum ferritin and hemoglobin were observed. Thus, the following are recommended: 1. A similar research in a larger population having longer exposure to lead should be carried out. 2. Health improvement of work environment must be taken into account for the prevention of lead intoxication.

Background and Aim: Observing educational rules and regulations on the part of educational staff is obligatory because these rules facilitate different tasks such as students’ registration, taking credits, etc. Furthermore, it influences future personality development of students and is followed by the Ministry of Health as a factor in evaluating of Universities. The present study was designed to assess the observation of educational rules and regulations by educational staff in different faculties of Birjand University of Medical Sciences in 2006.Materials and Methods: In this descriptive- analytical research, 159 students (as educational informants) from three different faculties- medical, nursing, and paramedical -in Birjand University of Medical Sciences were studied by means of two checklists. Checklist 1 concerned obeying educational rules in all fields of study and all faculties and number 2 was about clinical stage. The obtained data was analyzed using X2 test and SPSS software and P<0.05 was taken as the significant level.Results: In this survey, checklist number 1 was completed for 159 students, of whom 63 cases (39.6%) were medical students, 51 (32.1%) nursing students and 45 (28.3%) were paramedical ones; and checklist number 2 was filled in for 81 students. 43.4 % cases had credit adding and dropping which had been done under relevant rules and certifying of their tutors. Of these students, 35.8 % had not signed their final credit verification forms; 74.6% of these students studied medicine, 13.7% nursing, and 6.7 % paramedical fields. Thus, the differences between the faculties were significant (P<0.001). Rules concerning temporarily transferring students had been observed in all the three faculties. 41.4 % of students in clinical stage said being an on-call intern was compulsory and 58.6% stated it as voluntary. 89.7% of students thought leaving the hospital was possible during leave-hour and the rest didn't answer this question. 84.5% of students approved the presence of an organized educational curriculum in clinical stage. 62.1% of students said rules of on-call substitution were not obeyed.Conclusion: According the obtained data signing of final credit verification forms, being on-call interns, and on-call substitutes must be emphasized more than before by educational staff so that promotion of observing educational rules and regulations would lead to qualitative and quantitative results in education and this would elevate the position of this university among the other medical universities in our country.

Background and Aim: Uncontrolled population growth is actually an important threat to both the future health of the environment and economy. Decreasing the rate of fertility is considered as a vital index towards establishing smaller families, stabilizing population growth, and wellbeing. The present study was done to determine the frequency of unexpected pregnancy and factors related to it.Materials and Methods: This descriptive study was done on pregnant women referring to Mashhad maternity wards in 2004. A total of 400 pregnant women who had referred to maternity wards of Mashhad hospitals were selected through cluster sampling. Their individual fertility behaviors and their contraceptive measures were recorded by means of a questionnaire and then analyzed by SPSS using X2 and t test at the significant level P<0.05.Results: Totally, 143 cases (35.75%) had unexpected pregnancy and the rest 257 cases (64.25%) had planned pregnancy. In unexpected pregnancies mean marital age , mean first pregnancy age ,mean number of children, and mean maternal age were higher than those in mothers with planned pregnancies respectively (P<0.001). Variety of contraception methods was more in unexpected pregnancies. Type of contraception and husband’s cooperation in family planning were also significantly different between the two groups (P<0.001). Interrupted intercourse was the most common method of contraception in unexpected pregnancy group. More than one-fourth of those who had unexpected pregnancies were unaware of emergency methods of contraception.Conclusion: Reduction in unexpected pregnancies requires promoting general informational systems, improving family planning services; medical and health care staff attention to giving advice about applying contraceptive methods and the relevant complications of unexpected pregnancies and a more effective role of men in family planning.

Background and Aim: Osteoporosis is a systemic skeletal disorder, characterized by reduction of bone mass, deterioration of bone structure, increasing bone fragility, and increasing fracture risk. Prevention of osteoporosis is one of the most important issues in World Health Organization. This study was conducted to assess knowledge and attitude of female teachers on prevention of osteoporosis in Rafsanjan city. Materials and Methods: This study was a descriptive and analytic one the population of which included female teachers of Rafsanjan city and its sample size, based on a pilot study, consisted 445 female teachers .Relevant data was gathered by means of a researcher - made questionnaire having three sections. Section one: demographic questions, Section two: 30 questions about knowledge, and section three: 18 questions about attitude of teachers. After the validity and reliability of the questionnaire was approved, it was used for data collection. The obtained data was analysed applying SPSS statistical software, t-test, and one-way variance analysis at the significant level P<0.05.Results: It was found that many teachers (24.1%) were 36-40 years old and most of them, (94.4%) were married. Education level of 55% was either BA/BS or MA/M.Sc. 53.7% of the teachers taught in high schools and technical schools .Work experience of 40.9% of the subjects was 11-20 years. Total score of knowledge and attitude was 62% and 82.17%, respectively. Regarding their level of knowledge and level of education there was a significant difference between the teachers' total mean knowledge and educational degree on one hand, and their source, with respect to the disease prevention, on the other (P<0.05). Comparison of attitude and level of education also showed a significant difference between level of education and total mean attitude score (P<0.05).Conclusion: Results indicated that teachers did not have acceptable knowledge, but they had optimal attitude toward prevention of osteoporosis. These results approve of the necessity for more education regarding osteoporosis prevention, which is one of the duties of health-care professionals.

Background and Aim: Thyroid nodule which is not detected by palpation but is diagnosed following a radiological procedure or during surgery is called thyroid incidentaloma. This study was designed to investigate prevalence of sonographic thyroid incidentaloma in Isfahan in 2006.Materials and Methods: In this cross-sectional study, 2523 adults were randomly selected through cluster sampling method. 2045 of them had normal thyroid examination results; 234 of these were randomly selected for thyroid sonography. Their thyroid stimulating hormone (TSH) and urinary iodine concentrations (UIC) were measured.Results: Prevalence of thyroid incidentaloma was 13.2%. Age of people with and without incidentaloma was 46.1±12.4 and 38.4±12.1 respectively (P=0.002). The prevalence was higher in females than males (19% vs. 10%, P=0.002). Labor frequency in women with thyroid incidentaloma was higher than that of the healthy group (93.7% vs 58.8%, P=0.001). Levels of TSH were not different in the two groups. Median UIC in incidentaloma group (14 3g/dL: 2-40) was significantly lower than that in the healthy group (20 3g/dL: 1.8- 42), (P=0.02). Mean diameter of nodules was 8.14±3.43 mm.Conclusion: Prevalence of thyroid incidentaloma was 13.2% in Isfahan. This is similar to obtained results in other communities. The disorder was higher in females than in males and increased with age.

Although cardiac tumor is rare, cardiac myxoma is the most common primary cardiac tumor in adults (50%- 70%). Myxoma, as a benign neoplasm, can develop in any chamber of the heart; the most commonsite being the left atrium (75%) with an overall incidence of about 0.5/million/year. Nowadays echocardiography plays a crucial role in early precise diagnosis and treatment and, therefore, prevents life- threatening complications. Occurrence of cardiac myxoma with valve origin, particularly in the right atrium has rarely been reported worldwide (fewer than 10 cases). In this report, we present a young patient that was admitted to the hospital with pleuritic chest pain due to right pulmonary embolization and infarction and the unusual finding of septal leaflet of tricuspid valve origin of tumor with invasion of villous lesions to the right ventricle.

Primary non-Hodgkin’s lymphoma usually presents itself as a rapidly growing mass inside thecardial chambers or myocardium. Most prevalent symptoms of the disease are arythmia, treatment-resistant cardial deficiency, pericardial effusion, and embolic strokes. However, secondary lymphoma is mainly infiltrated inside the cardial tissue. This article is a case report of a non-Hodgkin’s lymphoma in a young boy; whose clinical manifestations were palpitation, exercise-induced asthma, and symptoms of right-heart failure.