Research in Medicine
Year:2000 | Volume:24 | Issue:2|Papers Count:14

Objectives and methods: This was an intervention field trial to determine the effects of anutrition education program (a modudle prepared specifically for the propose) on the nutritional knowledge and attitude of volunteer Health care workers of Tehran University of Medical Sciences (TUMS) in city of Tehran in 1999. The study population consisted of 121 female health care workers from four randomly selected health care centers. A preliminary questionnaire to obtain personal and demographic information, as well as nutrition knowledge and attitude was developed and pretested in the field. All health care workers from two out of the four health care centers entered the study as the intervention group (65), while health care workers of the other two centers entered the study as the control group (56).Results: The mean age of the health care workers was 30.6±8.4 years, 31 of them (74.4) were married and 110 (90.9%) housewives. The mean knowledge score before the intervention was 67.4±10.8 (out of 104), while the mean attitude was 37.4±5.5 out of 52. There was no statistically significant difference in the knowledge and attitude scores among the four centers. After the education program, the score .of nutrition knowledge of the intervention group increased significantly, from 67±12.7 to 92.1±5.5 (P < 0.001), while no significant change in the knowledge of the Control Group was observed (from 68±7.3 to 69±t9.2). The difference in the knowledge pre-test and post-test between the intervention group (25.12±12.58) and the control group (1.5±t9.2) was statistically significant (P<0.001). The attitude score of the Intervention group increased significantly after the education program, from 37.4±5.8 to 43.9±2.6 (P<0.001), while no significant change in the attitude of the control group was observed (from 37.4±5.8 to 36.1±4.6). The difference in the attitude pre-test and post-test between the intervention group (6.5±6.5) and the control group (-1.3±5.5) was statistically significant (P<0.001).Conclusion: It is concluded that a nutrition education program using a well-prepared module can increase the nutrition knowledge and improve the nutrition attitude of volunteer health care workers.

Background: Osteoarthritis of the knee is a major problem and one of the most causes of disability in the elderly. Woman tending to have more frequent and more severe evidence of knee osteoarthritis. Because of the possibility, that hormonal changes may influence the disease, the present study was designed to investigate the association between pregnancies and osteoarthritis of the knee.Methods: In a case-control study, containing 194 cases and 194 age matched controls, data were collected for body mass index (BMI) and numbers of previous pregnancies. The mean (±SD) values of these variables were compared by student-t test in the two groups. The association between pregnancies and osteoarthritis of the knee was estimated by adjusted odds ratio after adjusting for BMI, using multiple logistic regression models.Results: Women with osteoarthritis of the knee had more pregnancies (7±3) than control (6±3), P=0.005. There was an increased risk of knee osteoarthritis in the group with women who had more than six pregnancies (as compared with women who had six or less pregnancies), adjusted OR=1/95, (95% confidence interval, 1.24-316, P=0.003).Conclusion: This study indicates that having more than six pregnancies is associated with increased risk of knee osteoarthritis.

Lymphomas accounts about 10% of all childhood malignancies, and non-Hodjkin's lymphomas are the major group of lymphomas in children, so it's necessary to increase our knowledge about this subject.This descriptive study was performed on 60 cases of non-Hodjkin's lymphoma aged 0-14 years, referring to Mophid Ped. Hospital in seven years (1369-1375) the considered parameters are type, grading, sex, age and site of involvement. Among the patients, 42 (70%) were male and 18 (30%) were female. 52 patients (86.6%) had high gradelymphoma and Burkitt lymphoma was seen in 39 (65%) of subjects. Thirty patients (50%) had 0-5 years. Extranodal involvements (ilium, ovary, nasopharynx, small intestine) were seen in 36 (60%) patients.The findings in the present study were similar to those reported from other countries. Although further studies should be done for approaching the better results.

Today, decrease of bureaucrasy in administrative system is considered as a main factor for efficiency in these systems. This policy has been offered by the Ministry' of Health and Medical Training (Education) for applying in the all health care networks of IranAccording to this policy, health center of Chaharmahal and Bakhtiary has executed(carried out) a project in Boroujen health care, since 1373 as the above-mentioned title. The first stage of this planning has been design in three scales: 1) Indicators referring to administrative bureaucrasy and super fluous regulations, 2) Indicators referring to decon tralization, in order to execute the physician management in the health care centers, 3) Expenses related to the administrative regulations (ruler). These three scales determined and evaluated situation of centralized management and administrative bureaucracy in the networks.Then by providing necessary facilities, training personnel, and administrative and financial in stractions; actual executions performed in the health center networks. Finally the studied indicators in the first stage investigated for determining the efficiency rate. The ultimate result showed valuable improvement of indicators in three above mentioned scales.

The occurrences of pregnancy induced hypertension in low-income young nulliparous women are confirmed in different reports and increase the risk of preec1ampsia. More knowledge on the role of nutrients especially calcium demonstrates its major role in regulating blood pressure. Sufficient in take of pregnancy can prevent pregnancy induced hypertension. This study was conducted to evaluate efficacy of one gram calcium supplementation (Calcium carbonate) on the blood pressure of young normotensive pregnant women.The study population consisted of 58 pregnant women visited in Mahdieh Hospital in Tehran, the samples were selected sequentially among nulliparous normotensive pregnant women under 25 years old, without disease or drug usage (except for iron supplements).The study populations were randomly subdivided into case and control groups who received calcium or placebo from 26th week of pregnancy the results indicated that calcium supplementation prevents systolic and diabetic hypertension in case group. There was significant difference in alterations in blood pressure between case and control groups (3.7 vs 6.1, respectively). Daily calcium and phosphoros intake from food stuffs was lower than recommended Daily allowance (RDA) in both groups.This study demonstrates that daily intake of 1 gram calcium supplementation can induce a relation of 44.83 % in systolic and diastolic blood pressure which can play a major role in reduction of pregnancy induces hypertension.

Postpartum thyroiditis is one of the autoimmune thyroid dysfunctions which occurs during 12 months after delivery. Transient episodes of hypo and hyperthyroidism in this disorder leads to maternal psychological and physical problems. Irreversible hypothyroidism occurs in a number of mothers. The prevalence and clinical course of the disease haven't been evaluated before, so this study was conducted to follow this object in 1998- 1999in Tehran.Materials and methods: One thousands and forth (1040) mothers visited in 5 health-center in Tehran were investigated for the symptoms of hypo and hyperthyroidism and the presence of goiter according to who classification.T3, T4, T3Ru, TSH, Anti Tg and Anti Tpo were measured in at 3, 4.5, 6 and 9 months postpartum those with abnormal thyroid function tests were included in patient group and others considered as control group. Patients in each visit underwent thyroid sonography and the results compared with control group.Results: The prevalence of thyroiditis in study population was 11.4%of who 68 were cases of hypothyroidism42 were of hyperthyroidism and 9 had transient postpartum hyperthyroidism before theoccurance of hypothyroidism. One patient was affected by Graves. Among patients, with hypothyroidism, 35 subjects underwent treatment with levothyroxine due to the severity of symptoms of whom 6 had recurrent hypothyroidism after discontinuing at 12 months postpartum.Significant goiter was present in 21.8 % and 6.7% of patient and control groups, respectively (P<0.001). The percentage of positive anti thyroid anti body in case and control groups were as follows respectively for Anti Tpo (61.5%, 19%) and for Anti Tg (58%, 6%) (P<0.0001).Special sonographic textures (hypoecogenicity and heterogenecity) were observed in more than 96% of patients and less than 7% of control group (P < 0.001). There was no significant association between the incidence of thyroiditis and, past medical history or family history of thyroid disorders, mother's age, sex of newborn, breast feeding and the number of deliveries.Conclusion: This study revealed high prevalence of postpartum thyroiditis in Tehran. Hypothyroidism mostly needs to be treated in mothers and some of them effected by irreversible hypothyroidism.

Chronic renal failure is an uncommon disease in children with some difference in the etiology in different countries. In this study on 180 children (From 1987 to 1997 in Shiraz) with age range of 3 months to 15 years (mean 8.6±4.2 years). The male to female ratio was 1.57: I. The etiology of chronic renal failure in decreasing order of frequency were: reflux nephropathy (25%), glomerular diseases (15%), heredofamilial disorders (15%), urinary stone and nephrocalcinosis (12%), pyelonephritis without reflux or other anomalies (9%), vascular disorders (8%), hypoplasiaor dysplasia (3%) and unknown (14%). In 56% of patients with reflux nephropathy, the cause of reflux was not found (primary). The frequency of disease had a positive correlation with age, ranging from 11.1% in infancy to 38.4% in 10 to 15 years. In conclusion reflux nephropathy which can be a preventable disease is the most common, and urinary stone is a relatively common cause of chronic renal failure in this center, which is quite different from reports of most European centers

Endemic goiter and iodine deficiency disorders (IDD) are prevalent in Iran and IDD control program has been implemented since 1989. To monitor IDD control program, this survey was performed in 1996.26178 schoolchildren, aged 8 to 10 years were selected by probability proportionate to size randomly in 26 provinces of Iran, for goiter staging. In 2836 pupils blood and urine samples were obtained for measurement of T4, T3 and TSH and urinary iodine levels, by radioimmunoassay and digestion methods, respectively. Mean serum T4, T3 and TSH were 9.7±2.1mg/dl, 159±62ng/dl and 2.2±2.7 mU/ml. No significant difference was observed between girls and boys or schoolchildren in urban and rural regions. In all, 8 pupils had T4>12.5mg/dl with T3>240ng/dl; in which 7 had increased TBG and normal FT4I and FT3I. One child had thyrotoxicosis. In 3.9% TSH was>5mV/ml and 9 children had TSH>10mV/ml; in which 7 had normal FT4I and T4 (subclinical hypothyroidism). In 2 pupils increased TSH and decreased FT4I was present. Median urinary iodine excretion was 20.5mg/dl, without significant difference between both sexes and urban or rural inhibitants.It is concluded that IDD prevention program has been effectively implemented in I.R. Iran. There is no evidence of increase in prevalence of thyroid derangement in schoolchildren of 8 to 10 years old.

To determine the prevalence of intestinal parasites in school children of Shariar, 1902 students (58% male, 42% female) were randomly selected from 22 schools in rural and urban regions of Shahriar. After filling out a questionnaire from the selected students, fresh stool samples were examined for the presence of intestinal parasites and determining this tynos.The age of study population was between 6 and 15 years (mean age 9.3 ys). The rate of parasitic infection among girls and boys were 6% and 64%, respectively (P<0.005). The prevalences of pathogenic protozoa including Giardia and Entamoeba histolytica were 26% (22% in urban areas 28.4 % in rural areas) and 6.7% (5.6% in urban areas, 28.4% in rural areas), respectively.The prevalences of non pathogenic protozoa were as follows; E.Coli 27.8%, iodamoebabutschlii12.1% endolimaz nana 7.8% chilomastix mesnili 6.5 %, Dientamoeba frogilis 4.9% and trichomonas hominis 2%. The prevalence of helminis was as follows. Enterobius vermicularis 3% (1.8% in urban areas, 3.5% in rural areas). Ascaris 2.5% (2% in urban and 2.5% in rural regions), trichocephalous 1% (1.2% in urban regions and 8%in rural regions). Dicrocoeloum 3%, taenicand hoole worms 2%, Trichostrongylus and Fasciola 1%.In this survey high prevalencs of Giardia (pathogenicprotozoa) and E.Coli (a non pathogenic protozoa) are remarkable

This study was conducted to determine the epidemiologic pattern's of shigellosis in children in Qazvin children hospital during 1375-76. The study of 166 children with diagnosis of shigellosis (shigella was grown in sic) during 2 years showed that: prevalence of shigellosis were high in male and summer, peak age of shigellosis was in 1-4 years (65/7%).Most common symptoms were fever (91.6%), diarrhea (89/5%), vomiting (73.5%), siezure (36.8%), dehydration (15.71%). Bloody diarrhea was seen in 37% of children. Most children had abnormal S/E (80.1%) and Bandimia was in 58.1%. Antibiogram of SIC showed that most sensitivity was with nalidixic acid (98.7%), most resistance with Ampicilin (91.8%).

The birth weight of a newborn is a significant determinant of neonatal and postnatal infant mortality. Maternal weight gain during pregnancy is one of the significant factors that influences on birth weight. Our purpose of this study is that to determine the effect of maternal-eight gain on neonatal birth weight.This descriptive study is done on women who delivered in Mahdieh Hospital since Mehr 1376 to Azar 1377. The total of 354 women who delivered at term was included and following results were derived: The mean birth weight of newborns was 3260gr and mean weight gain of mothers during pregnancy was 9.16 kg.In nulliparous women with increasing weight gain, the risk for low birth weight (birth weight 2500gr) decreased and probability for high neonatal birth weight (birth weight 4000gr) is increased (P<0.0005) but this coordination was not present in multiparous women and result was not significant.