QOM UNIVERSITY OF MEDICAL SCIENCES JOURNAL
Year:2020 | Volume:13 | Issue:11 |Papers Count:9

Background and Objectives: The duty of every healthcare system worldwide, is to address needs and problems associated with community health. The current study was performed aiming at identifying and prioritizing the most important needs of Jamkaran village in Qom province and providing applied and useful interventional suggestions in order to solve the problems of the village. Methods: In a cross-sectional study, community assessment was performed in Jamkaran village in Qom province based on the North Carolina Model and according to MPH model developed by the Tehran University of Medical Sciences. The community assessment process was carried out in 8 stages in 6 different areas, including health, education and culture, economics and employment, social and civil rights, and security and urban services. Then, they were prioritized using the Scoring Matrix method. Results: In the village, 48 problems were identified in 6 areas, the most important of which, were in health (27%), urban services (25%), social and civil rights (20. 83%), economics and employment (12. 5%), education and culture (10. 4%), and security area (4. 17%) areas, respectively. The highest score of Matrix table was obtained to be in urban sanitation system (15 scores), shortage of park and green space (14 scores), unemployment (13 scores), non-communicable diseases (12 scores), and lack of public library (12 scores), respectively. Conclusion: Jamkaran faces with a wide range of social, economic, cultural and health problems, but the most of the problems of the village was related to health area, which requires serious attention of the authorities in all areas.

Background and Objectives: Clostridium difficile is a gram-positive obligate anaerobic bacillus. Accurate and rapid diagnosis of this bacterium as well as assessment of its drug resistance pattern are one of the important issues in controlling infections caused by C. difficile. The purpose of the present study was to detect toxicogenic C. difficile and to evaluate drug resistance pattern of these strains to routine therapeutic drugs. Methods: A total of 68 samples were collected from patients hospitalized in hospitals of Qom province. All samples were rapidly cultured in the specialized CCFA Agar medium. After these procedures, the bacteria were used for DNA extraction and then PCR was performed on the cdd3 gene for definitive detection of the bacteria. Finally, the presence of A and B toxins’ genes was determined by PCR and resistance to metronidazole, vancomycin, and clindamycin, was determined by agar dilution method. Chi-square test was used to analyze the results. Results: In this study, 6 isolates had A and B toxins, the highest antibiotic resistance was against clindamycin (45. 45%) and metronidazole (36. 36%), and all the isolates, were sensitive to vancomycin. Conclusion: Drug resistance pattern in the obtained strains still introduces vancomycin as the treatment of choice.

Background and Objectives: Drug abuse can have long-and short-term effects on the cognitive function of individuals due to changes in brain structure and function. These effects often manifest themselves in the form of chronic and acute neuropsychological abnormalities. The purpose of this study was to investigate several cognitive functions, i. e., continuous attention, decision-making, and response inhibition in methamphetamine-dependent individuals Methods: A total of 42 patients with methamphetamine dependence as patient group and 38 employees of Forghani Hospital in Qom city as control group, were selected using convenience sampling. The research sample carried out continuous performance, Iowa risk taking and colorword Stroop tasks tests. Results: Multivariate analysis of variance showed that there was a significant difference between patients and healthy groups in terms of continuous performance, Iowa risk taking and color-word Stroop tasks. The difference in these tests, was in such a way that the healthy group performed better compared to the patients in terms of assignment error response (p = 0. 018), removal (p = 0. 049), fine (p = 0. 039), interruption time (p = 0. 030), and interference score (p = 0. 043). Conclusion: This study indicated that methamphetamine has a serious effect on a number of cognitive functions, which leads to disruption in many other psychological functions in these individuals. Failure in decision making and inhibition to control consumption, aggressive and impulsive behaviors, learning deficits, lack of reasoning, and the ability to make the right decisions in personal, educational, occupational, and interpersonal areas are a few of these cases.

Background and Objectives: In obese people, 5-10% reduction in initial weight can decrease the obesity induced risks. Therefore, it is important to identify the predictive factors effective in weight loss maintenance. The present research was conducted to determine the role of important predictive factors in weight loss maintenance. Methods: For this purpose, a total of 200 women with obesity, were selected using convenience sampling. After explaining the study aims and obtaining the permission to enter the study, they were asked to complete the research tools, including Multidimensional Self-Body Relationship Questionnaire, Three-Factor Eating Behavior Questionnaire, Treatment Outcome Expectations, Weight Lifestyle Self-Efficacy Questionnaire, Caring Environment Questionnaire, Rosenberg Self-Esteem Scale, Depression, Anxiety, and Stress Scale (DASS-21), Multidimensional Perceived Social Support Scale (MSPSS), and Dichotomous Thinking in Eating Disorders Scale (DTEDS). Data were analyzed using SPSS software and Pearson correlation and step by step regression statistical methods. Significance level was considered to be p < 0. 05. Results: The results of the research showed that variables of weight lifestyle self-efficacy, body image, self-esteem, dichotomous thinking, and perceived social support predict 39. 8% of variance of successful long-term weight loss maintenance in the participants. Conclusion: The psychological and behavioral factors play an important role in successful long-term weight loss maintenance in obese subjects. Consideration of these factors seems necessary in weight loss programs.

Background and Objectives: Given the advances in treatment and use of new therapies in kidney transplantation, there is always a need to evaluate the survival of graft and patient and to investigate the effect of new therapies. Therefore, the purpose of this study was to assess the survival rate of kidney graft and patient in patients transplanted in ShahidHasheminejad hospital during 2008-2013. Methods: This retrospective study was conducted on 750 transplant patients. Using a checklist, demographic characteristics of recipients and donors, kidney failure (ESRD) characteristics, history of transplantation, transplantation source and its function, transplant rejection, and patient's status in last follow-up, were recorded. The data were entered into SPSS software version 23 and the survival rates of the transplanted kidney and the patient, was calculated using life tables and Kaplan-Meier analysis. Results: According to Kaplan-Meier analysis, the Mean survival time of the patients was 85 ± 1 month. The survival rate in patients aged over 40 years and graft survival rate in patients with unknown causes of ESRD and diabetes, were lower. The survival rate of transplanted kidneys in patients with DGF was lower than in patients with SGF or EGF. Sex, blood group, pre-transplantation dialysis, transplantation source, and donor sex had no effects on the survival of graft and patients. Conclusion: The findings of the present study showed that the 7-year survival rate of the transplanted kidney and patient in patients who underwent transplantation, was 79% and 80%, respectively, and the mean survival time of graft and patient, were 84 and 85 months, respectively.

Background and Objectives: Sleep disturbance and anxiety are common problems in patients undergoing hemodialysis, which can be influenced by use of complementary medicine. Therefore, the objective of this study was to determine the effect of guided imagery on anxiety and quality of sleep in patients undergoing hemodialysis. Methods: This clinical trial study was carried out on 70 hemodialysis patients, who were divided into two intervention (35 subjects) and control (35 subjects) groups using block randomization method. In addition to receiving usual care, the intervention group received a compact disc (CD) of guided Imagery through headphones for a consecutive period of 4 weeks, and the control group received just the usual care. At the beginning and the end of the study, the Spielberger Anxiety Inventory and Pittsburgh Sleep Quality Index, were completed. Data were analyzed using descriptive and analytical statistical tests (independent t-test, paired t-test, and covariance analysis) using SPSS Version 16 at a significant level less than 0. 05. Results: The results of the study revealed that the prevalence of state and trait anxiety and the sleep quality of patients in the intervention group, were 54. 42 ± 3. 58, 52. 05 ± 3. 15 and 8. 45 ± 2. 31, respectively, and in the control group, were 47. 91 ± 7. 21, 49. 37 ± 5. 49, and 6. 51 ± 2. 82, respectively; so that the mean anxiety scores in the intervention group, was significantly higher than the control group (p < 0. 001). After the intervention, the anxiety score in the intervention group, was 43. 05 ± 2. 15 and 42. 48 ± 2. 06 and in the control group, was 47. 37 ± 6. 38 and 49. 40± 5. 79, respectively, and the mean of the anxiety scores in the group was 47. 37 ± 6. 38, so that the mean anxiety score in the intervention group was significantly lower compared to the control group (p < 0. 001). Moreover, the sleep quality score before the intervention was 8. 45 ± 2. 31 in the intervention group, which became 6. 54 ± 1. 93 after the intervention. Sleep quality score in the control group before the intervention, was 6. 51 ± 2. 82, which became 6. 02 ± 2. 47 after the intervention. Conclusion: Use of guided imagery reduced anxiety and improved sleep quality in the hemodialysis patients. Thus, use of this technique is recommended as a non-pharmacological approach to reduce anxiety and improve the quality of sleep in patients undergoing hemodialysis.

Attitude to humankind will have different effects on providing health services. Although, more attention is being paid to physical dimension of health, many researchers and health service providers consider the concept of health beyond physical health. Accordingly, the biopsychosocial model of health, which has been accepted by scientific communities for many years, has a missing link called spiritual health. In recent years, different models have been proposed to investigate the relationship between spiritual health and other dimensions of health in the form of a holistic approach to humankind. In spite of the variety of these models, the fundamental challenge is the actual place of spiritual health in comparison with other dimensions. In this study, it was attempted to address the status and weight of spiritual health and its relation to other aspects of health from the Islamic point of view.

Background and Objectives: Anemia is a common complication of chemotherapy. In order to resolve this problem, multiple red blood cell transfusions are administered, leading to iron overload. Given the confirmation of positive correlation between the increased bone marrow iron stores and adverse response to the treatment in the previous study, the effect of iron on the proliferation of acute lymphoblastic leukemia (ALL) cell lines cell lines and its underlying mechanism were investigated in the current study. Methods: Nalm6 and CCRF-CEM cell lines were selected as representatives of B-ALL and T-ALL Immunophenotypes and were treated with different concentrations of holo-transferrin (1-120 μ M) and ferric ammonium citrate (FAC) (400-25000 μ M). The cellular iron uptake was confirmed by AAS test. The cell proliferation and levels of intracellular free radicals (ROS), were evaluated by MTT and flow cytometry, respectively. Statistical analysis was performed using GraphPad prism software by one-way ANOVA test. Results: The effect of holo-transferrinon cell proliferation was not significant. However, FAC enhanced the proliferation rate of both ALL cell lines over 50%. Evidence showed that iron induced intracellular ROS, so that FAC in the concentration of 400 μ M may induce the intracellular ROS over 50% (55. 27 6 6. 36% vs. 100%, p < 0. 001). Conclusion: Iron can support these cancerous cells by inducing ROS and augmenting leukemic cell proliferation. Therefore, the present study suggests that the volume of the injected blood in ALL patients should be minimized to prevent iron overload.