Journal of Kermanshah University of Medical Sciences
Year:2008 | Volume:11 | Issue:4 (35)|Papers Count:14

Introduction: Unhealthy nutrition increases the risk of diseases incidence. Some researchers suggest that the interventional programs related to the prevention of chronic diseases including preventive nutritious recommendation should be started in childhood period especially in schools. The purpose of this study was to assess the effectiveness of an educational health intervention based on the Health Belief Model (HBM) in order to reduce junk foods consumption among the primary school children of Araak / Iran (2003-2004).Materials and Methods: The present double blind randomized semi-experimental study was carried out in the form of a clinical trial on 1200 students in two groups called the experiment and the control (600 in each) from schools randomly selected in two stages, classification and cluster sampling. The study of variables was comparably assessed before and three months after the educational intervention both in the experiment group and in the control one. In the experiment group, the educational intervention was based on HBM framework during a three-month period, in which, the educational messages were designed to increase the students' perception of diseases, susceptibility, severity and its preventive methods, as well as, the benefits and barriers of nourishing behaviors, and also self efficacy. But in the control group, the educational intervention was based on the current methods. Two questionnaires and a check list were used for data gathering. Frequency matching method was used to match the two groups in terms of age, gender, educational degree and social class. The reliability of the questions was determined by "test retest". Data were analyzed by using c2, McNemar, ANOVA, Pooled t-test, Paired t-test and followed by scheffe test for multiple comparisons.Results: The mean age of the students (50% male and 50% female) was 8.63±0.092. Before the intervention, there was no significant difference regarding the socioeconomic class, age, gender, educational degree and the average expenses of the consumed junk foods between the two groups. Also before the intervention, the results showed that 15.6% of the experiment group and 12.3% of the control group didn't use to have breakfast. After the intervention, these values were reduced to 11% and 13.6% in the two groups, respectively. The difference in the experiment group was significant (P<0.05), but in the control group, it wasn't statistically significant (P=0.566).In baseline, 71.6% of the experiment group and 59.1% of the control group were daily consuming junk foods (p<0.001). After the intervention, these figures changed into 62.9% and 67.9%, respectively (p<0.05). Also the average expenses of the consumed junk foods from October to May increased from 44.12 to 46.02 in the experiment group and from 41.29 to 54.59 in the control group. In other words, the increase in the experiment group was much less (1.6) than in the control group (p=0.05). After the intervention, no significant difference was observed or reported in the number of the consumers of the carbonated beverages in the two groups (p=0.204).Conclusion: The results of current study approved the existence of unhealthy nutritious behaviors among the primary school children, and that applying HBM framework was useful to modify some of these behaviors in a three-month occasion. Our findings also supported the feasibility of an educational health program based on HBM as well as welfare authorities' role in order to induce behavior changes against unhealthy nutrition in primary school children.

Introduction: Lichen planus (LP) is an inflammatory mucocutaneous disease with unknown aetiology. Many studies have been reported regarding probable relationship between LP and liver diseases especially hepatitis B and C and they have a lot of different consequences. These studies evaluated the relationship between LP and hepatitis B and C in Hajdaee dermatology clinic in Kermanshah, from 2004 to 2005.Materials and Methods: In this case-control study 57LPpatients (37 male, 20 female) have been documented pathologically and 57 selected healthy persons (36 male, 21 female) as a control group were screened for HBS antigen and HCV antibody by using ELISA method. The comparison of the results in these two groups were analysed by chi square test according to the distribution of age & sex.Results: The mean age of LP patients and the control group were 43.7 and 43.88 years old respectively. HCV antibody was positive only in one case (1.7%) of 57 LP patients and also one case (1.7%) of the control group (p=1). HBS antigen was positive in 3 cases (5.3%) of 57 LP patients and no one of the control group was positive accordingly (p=0.079). Conclusion: Despite of some countries' observations such as Italy that show an association between LP and hepatitis in Kermanshah province, however, no significant associations were found between LP and hepatitis B and C. Therefore the routine tests such as HBS antigen and HCV antibody regarding hepatitis B & C for Kermanshah LP patients is not necessarily needed.

Introduction: Hypertension (HTN) is one of the most common risk factors of cardiovascular diseases in adults and it is clear that HTN in adults starts from the childhood. Cardiovascular diseases in adults can be decreased by determining and controlling risk factors on blood pressure (BP) in children. This study evaluated & investigated the risk factors & determinants respecting blood pressure in school children in Shiraz province. Materials and Methods: 1244 school children (663 boys and 581 girls) were chosen in a cross - sectional study by using multistage random sampling. Height, weight and diastolic & systolic BP in children and their parents' BP were measured by using standardized methods.The other data was obtained by using questionnaire & the manner of interviewing. The data was analyzed by using statistical partial unity manners & multiplex linear regression.Results: It was shown that systolic BP (SBP) in children was affected by height, body mass index (BMI) living district and their parents' (SBP), but children's diastolic BP (DBP) was just affected by height,( BMI) and living district.Conclusion: The amount of BP in children is not affected by age but affected by height and (BMI). Therefore, HTN in adults can be prevented by controlling obesity in childhood. Meanwhile, children with a history of HTN in their families and a history of environmental stresses and the other risk factors in relation with HTN should be nursed & observed so as to control or delete these risk factors until having healthy adults in terms of cardiovascular health in the future.

Introduction: Pneumonia is an inflammation of the parenchyma of the lungs. Most cases of pneumonia are caused by microorganisms, but there are several non-infectious causes accordingly. Pneumonia is a considerable cause of mortality in childhood, throughout the world, particularly in developing countries. This study, according to this important matter, evaluated & inspected all of the patients with diagnosis of pneumonia who were bedridden in Razi hospital in Kermanshah. Materials and Methods: All of the patients with diagnosis of pneumonia, who were admitted in pediatric wards of Razi hospital in Kermanshah in 2008, were 107 cases that were chosen on the base of CDC criteria. Then the data were collected from medical records including Age, sex, underlying diseases (cardiac, deficiency of immunity, GE reflux, and disturbance of gag reflex) duration of bedridden, a need to be bedridden in ICU and a need for ventilation. Collected data were analyzed by descriptive statistics.Results: Proportional frequency of pneumonia was 6.39%, Frequency of pneumonia in males was 60.74% and in females 39.25%. Mortality rate was 60% in males and 40% in females. The common season of pneumonia was 35.51% in winter, and the most common mortality rate was 46.66% in autumn. pneumonia in underlying diseases was 36.44%, mortality rate in this group was 66.6% and the most common age of mortality was under one year old 66.6%, the need for ICU was 29.9% and the need for ventilation was 15.88%.The most common ordered antibiotics were ceftriaxine 50.46% & chloramephenicol 0.93% repectively.Conclusion: In this study remarkable numbers of patients who were admitted to the hospital due to pneumonia had at least one underlying disease, but mortality due to pneumonia was the most common rate in this group particularly in cardiac underlying diseases. For this reason prophylaxis of pneumonia especially in patients with underlying diseases and usage of vaccination in this group is highly recommended.

Introduction: Benefits of regular physical activity are well documented in all age groups; Nevertheless, a sedentary lifestyle among adolescents, adults and elderly people in prevalent in nearly all parts of the world. A decline step in activity levels occurs in adolescence. The present study is designed to test: 1) determining the distribution of adolescents on every single one of the stages of change model; 2) determining differences in recognitions, psychosocial factors related to physical activity and physical activity in terms of the stages of change model on practical behavior among adolescents.Materials and methods: In this cross-sectional study a cluster random sampling in 16 schools selected from 233 junior and senior high schools in Sanandaj, Iran resulted in a number of 1073 students (mean age= 14.37±1.6, 52% females, 48% males) who completed self-report questionnaires which were measured by selected benefited structures from Pender’s Health Promotion model consisting: perceived benefits, barriers, self-efficacy, enjoyment, interpersonal influences, planning to action, also preferences  and stages of change model Such experiments as Chi Square & ANOVA accompanied by Post-Hoc Scheffe and also Mann Whitney for the multistage comparison were used. Results: The distribution of the participants according to the stages of change model was as follows: pre-contemplation 12.2%, contemplation 17.2%, preparation, 22.5%, action, 18.8% and maintenance 29.3%. The results revealed that there are such differences as gender and age group in terms of the stages of change model.(p<0.001). Psychosocial and cognitive structures differed from pre-contemplation through maintenance significantly (p<0.001). The level of physical activities increased as individuals moved to higher stages of change. Conclusion: This study investigated Iranian adolescents' physical activity using the proposed framework adapted from Pender’s revised health promotion and stages of change model. The findings of this study have provided important information that it could be used to develop physical activity interventions in this and other similar populations. Intervention strategies to adolescents can be tailored based on the stages of change. Given reports declare that physical activity level concerning girls is dreadfully little & it is also reported that there is a less proportion in the action & maintenance stages in comparison with boys. There is a need to develop tailored interventions so as to promote physical activity based on theory and modes.

Introduction: Beta Thalassemia is the most common inherited bloody disorder, affecting synthesis of the beta globin chain of hemoglobin. The type of b-Thalassemia mutation affects on the b-globin chain synthesis that appears as bo, b+ and b++-Thalassemia. The presence of XmnI polymorphic site at the 5’ region of the Gg-globin gene affects on the rate of Gg chain synthesis and in some conditions influences on the production of HbF. These effects are important in the view of presentation of clinical symptoms in b-Thalassemia patients. Materials and Methods: In this researches one hundred ninety seven beta Thalassemia the Major and nine beta Thalassemia the Intermediate patients who had been registered in shahid fahmideh hospital in Kermanshah were studied. The XmnI polymorphisms in the region of 5’ to Gg gene was determined by PCR-RFLP procedure. The percent of Gg and Ag chains in HbF were determined by high performance liquid chromatography (HPLC). The HbF levels were determined by electrophoresis (according to patients files). Data were subjected to the chi square & analysis of variance (ANOVA).Results: Analysis of XMNI polymorphism from both groups showed that there were 32(16.3%) XmnI homozygote (+/+) and 44 (22.3%) XMNI heterozygote (+/-) in b-Thalassemia the Major group. In patients with b- Thalassemia the Intermediate 5 (55.6%) XmnI homozygote (+/+) and 2 (22.3%) XmnI heterozygote (+/-) were found. The mean level of HbF in b-Thalassemia the Major and the Intermediate patients was 95.3g/dl, 85.4g، respectively. Mean Gg/Ag ratio in b-Thalassemia the Major and the Intermediate patients was 2.5% and 2.3% respectively. In the present study while using ANOVA test we found that, in beta Thalassemia patients, the presence of XmnI polymorphic site increases HbF levels, Gg percent and Gg/Ag ratio (p=0.001). Conclusion: The present study has determined XmnI polymorphic site in b-Thalassemia the Major and the Intermediate patients from Kermanshah and has shown that the presence of this polymorphic site has had a positive influence on HbF production and Gg chain percent.

Introduction: Today sport is one of the important social criterion and athletes are trying to be a champion. Therefore, there is an increase in misuse of doping agents especially anabolic-androgenic steroid. This study was carried out to determine the prevalence of the doping agents' abuse among male bodybuilders' and to access their knowledge about their side effects in Kermanshah gymnasiums in the year 2004. Materials and methods: This cross-sectional study was carried out among male bodybuilders in Kermanshah gymnasiums under supervising of population research center during the year 2004. using the simple random sampling , the required sample size was 839. Data collection method was questionnaire which had been valid and reliable according to the similar researches which verified by experienced professors and a lot of questions to be asked about athletes' demography, doping agents' abuse and their knowledge about doping agents' side effects. Their knowledge was stratified from unawareness to awareness .Data were analyzed using SPSS and summarized in tables, charts and figures.Results: on the whole 839 bodybuilders filled out the questionnaires. The prevalence of the doping agents' abuse was 38.3% (322 athletes) whose mean age was 20.97+9.86. In doping agents abusers, 291 (94.5%) were less than 30 years old and 169 (53.5%) had high school Diploma. Cratin among 215 (66.8%) athletes and Nondrolone 138 (48.7%) athletes were the most common agents that have been used respectively. An increasing in muscle mass was prevalently the most important cause of using doping agents among 100 (31%) bodybuilders and power lifters. Only 127 (39.4%) people of the doping agents abusers had some knowledge about side effects of these agents on each six important organs of the body. Conclusion: In this study the prevalence rate of the doping agents' abuse among male bodybuilders was 38.3%. Therefore a lot of bodybuilders are using doping agents whereas most of them are young and because of the little knowledge about the agents' side effects an analytic study is highly suggested to be a base for the interventional studies in order to challenge to this really serious problem and decrease it consequently.

Introduction: To the best of authors’ knowledge, to date, no systematic study has been carried out in Shiraz to assess the extent, frequency, causes and major outcome(s) of home accidents in rural and urban areas of this city. Additionally, no comparative study has been undertaken to evaluate the trend of these accidents over a period of time, and finally, the morbidity and mortality rates of these accidents are unknown. The current study was, therefore, undertaken to address some of these issues.Materials and Methods: This is a descriptive analytical retrospective study in which data on home accidents for a period of 3 years (2000-2002) were collected from Health houses, Health centers and hospitals involved in the Home Accident Prevention Plan. They were then classified, based on the nature of injury, and were assigned to one of the following categories; burns, poisonings, sharp object injuries, falls on the level and from height, etc and analyzed by appropriate statistical tests. Gender, age, seasonal distribution and outcome of injuries were considered in data analysis.  Results: A total of 15402 accidents (4027, 5141, and 6234 cases for the years, 1999-2000, 2000-2001 and 2001-2002, respectively) had been registered during the study period. Accidents, in general, were more common (52.1%) in women (57.5%, 53% and 48% for the 3 consecutive years of the study period, respectively), than in men (47.9%). 66.3% of accidents occurred in urban and 33.7% of them in rural areas. Burns (66.5%), followed by injuries due to sharp objects (11.3%) were responsible for over 77.8% of all accidents. Of the total injured patients, 80.5% were treated completely, 18.1% were reported to be under treatment, 0.1% of injuries resulted in disability and 1.3% of victims died. Accidents were more prevalent in children under 5 years of age (25.3%), followed by 5-9 years of age (10.4%) and 15-19 years of age (10.1%). Seasonal distribution of the accidents revealed that they were more common in winter (29.6%). Similarly, most burns (33.2%) occurred during the winter months while the majority of poisonings (34%) occurred in summer.  Conclusion: The observation that burns form the most common cause of home accidents indicates area where preventative interventions might be usefully targeted.

Introduction: Ulcerative colitis (UC) is a chronic colonic mucosal disease with unknown etiology. Its frequency is rising in our country in recent years. With application of newer topical preparation in treatment of UC a true recognition of its colonic extension pattern is needed.  Reports from Iran are scarce. Reports from the world are contradictory. This study, therefore, was done to determine frequency of colonic extension in patients with UC in western part of Iran.  Materials and Methods: to this prospective sectional descriptive study which was prospected between the years (2002-2005) in Taleghani hospital affiliated of Kermanshah University of Medical Sciences, all patients with lower gastrointestinal bleeding and chronic diarrhea were referred to this hospital were enrolled and then were highly evaluated. Those patients who had three criteria of Copenhagen in favor of UC and had not received any treatment were enrolled to the study. Segments of colon that had criteria of colonic involvement in any colonoscopy grading between (0-4) were considered as diseased segments and classified as: 1. Proctitis, 2. Proctosigmoiditis, 3. Sigmoiditis, 4. Left-sided UC, 5. Pan colitis. Copenhagen criteria is included: 1. the history of diarrhea, bleeding, infection evacuation at least for a week; 2. colonoscopy criteria including circulated ulcer, vulnerable & granular membrane; 3. histopathology findings according to UC. analysis was done by SPSS using windows version 13. Data is expressed in numerical and percentage system.Results: 85 patients met criteria of ulcerative colitis. Mean age at the time of diagnosis was 34.09 years old. Male to female ratio was 1/0.8. The most frequent sites of colonic involvement in colonoscopy view were as follow: Proctosigmoiditis 30 patients (35.3%), Proctitis 20 patients (23.5%), Left-sided UC 18 patients (21.17%), Sigmoiditis 10 patients (11.77%), and pan colitis 7 patients (8.23%). Rectal sparing according to colonoscopy view was seen in 18 patients (21.17%).Conclusion: This study showed that Proctosigmoiditis in colonoscopy view is the most frequent site of involvement in UC in western part of Iran and frequency of rectal sparing in colonoscopy view from the beginning of disease is 21.17%. The reports are the same in Western Countries, but different from in Middle East & South-west of Asia accordingly.

Introduction: rubella is an acute serious viral infection in pregnancy. Rubella and resultant rubella syndrome (CRS) is still regarded as an important public health problem around the world. Islamic republic of Iran has implemented a nationwide vaccination program for measles-rubella in order to eradicate CRS in 1382. There is an imperative need for applied researches and collecting appropriate data in order to be informed about the result of the vaccination program. The aim of this research was to determine rubella immunity in relation with mothers admitted to postpartum unit of Be'asat hospital in Sanandaj. Materials and Methods: This study was analytic descriptive and was included 204 women who were bedridden in the postpartum ward. Patients were divided into two groups randomly using simple random sampling. The data about personal, medical and obstetric history were obtained by using questionnaire while blood sampling was daily taken from the above-mentioned women accessibly. Then the taken blood samples were immediately operated on because of serum separation action every day. Assay of specific IgG antibodies concerning rubella was determined by using ELISA test. The data were analyzed by ANOVA and T-Test using SPSS software. Result: Majority of subjects (31.4%) were 25-29 years old who had (35.8%) primary literacy and were city-dwellers (65.2%). In addition, 49% of them were primipara. 54.9% of them had history of rubella vaccination. 82.4% of them had no information about rubella complications in pregnancy. Overall; 93.7% of participants were immune to rubella. There were no significant association between immunity levels and other patients characteristics such as individual characteristics, obstetric and rubella vaccination histories and finally having rubella itself.Conclusion: According to our findings the general immunity level is acceptable, but it seems that this level of immunity isn’t merely the result of the mass campaign vaccination. As sporadic cases of disease may still occur and in view of the fact that rubella antibodies might wane after spending a period of time; a screening program is exceedingly necessary to determine rubella immunity levels before marriage or pregnancy and finally vaccination of susceptible persons.

Introduction: Herpes Simplex is a contagious infectious disease that usually can be transferred by such close contacts as kissing, sexual intercourse, during pregnancy from mother to fetus or/and during the birth in contact with the vaginal secretion. Herpes simplex virus (HSV) can produce a variety of infectious dangers by means of involving lips, involving genital system, skin, eyes and sometimes central nervous system and other visceral organs. In the first months of living fetus, congenital infection by Herpes virus can disturb the formation of organs and the offspring will be born with Microsephalia- Microphetalemia calcification in skull, chorioretinitis, kataract, liver calcification and heart defects. On the one hand a primary infection in pregnant women can have several dangers for the fetus, and on the other hand about HSVII when infection reappears, it’s possible to keep the fetus from the dangers of infection by choosing appropriate methods of childbirth. Having knowledge about the prevalence of this infection in pregnant women can make the health and care organizations to pay more attention to this infection and also it can help with choosing suitable treatment and prevention methods, and finally affected factors in this prevalence can be diagnosed.Materials and Methods: In this cross-sectional study 385 pregnant women that referred to some clinics of medical university in Kermanshah were evaluated by ELISA method regarding the presence of IgG antibodies against HSVII and additionally the prevalence of infection in this group was determined. Then the relation between infection of some variables like age, history of abortion, surgery, transfusion, etc. was determined as well.  Results: Prevalence of HSVII infection in the study group was 3.3%, and in the age group of 15-25 2.7% and 3.3% in the age group of 26-35 and 8.3% in the age group of older than 36 years old. Although there were a lot of dissimilarities among the group of study, there weren't any significant correlations between evaluated variables and HSVII pollution. Conclusion: Prevalence in of HSVII infection in compare with the other countries especially western countries is lower. In Iran this difference may be due to life style in Iran society, Iranian Culture and the religion in compare with western countries; it seams that free sexual behavior has important role in high prevalence of HSVII infection in western countries.

Introduction: Traumatic ruptures of the biceps tendon are rare, but serious, and usually involve the long head of the proximal insertion. Rupture of the distal tendon account for only 3% of all biceps tendon ruptures. A history of tendonitis, overuse, or anabolic steroid abuse may predispose tendons to rupture. Surgical repair, followed by a comprehensive rehabilitation program, was indicated to regain full strength and the range of motion in both flexion and supination. Frequency of the distal tendon rupture occurs between the age of 40 and 60. This kind of disease is more frequent in men than in women.Cases report: A 36 -year-old male weight lifter sustained a rupture of the distal biceps tendon during lifting a heavy weight .The athlete denied any history of tendonitis or anabolic steroid use. He felt a pop sound in his left arm and also an extreme pain plus decreasing the muscle strength. The patient wasn't able to bow his elbow or to turn it outwards in elbow joint area. After physical examination and taking MRI, he was diagnosed and verified by the test for traumatic ruptures of the biceps tendon. Immediately he was operated with a surgical repair using modified Boyd-Anderson and Muscle Splitting Model with two incision, then his left arm was placed in a cast for 6 weeks. Six months after surgery and physical therapy. He regained full range of motion and strength. After that he was released to lift weight without restrictions. Conclusion: This study shows exactly when a surgical intervention in order to repair a ruptured distal biceps tendon is necessary, appropriate conservative measures can be taken to allow the surgery to be delayed without any harm against the patient. The athletic trainer should be aware of how to recognize and how to treat this injury at once.