ARAK MEDICAL UNIVERSITY JOURNAL (AMUJ)
Year:2007 | Volume:10 | Issue:1 (38)|Papers Count:16

Introduction: Studies have shown that there is a relationship between metabolic syndrome and coronary heart disease. Hypertension is a common risk factor of both cardiovascular diseases and metabolic syndrome. The aim of this study is to determine the prevalence of metabolic syndrome phenotypes in patients with hypertension in Isfahan and Markazi provinces in center areas of Iran.Materials and Methods: This cross-sectional study was implemented in Isfahan and Markazi provinces in year 2001. Sampling method was random-clustering. 12514 people from both sexes who were above 19 years old were considered which based on ATP III, 1936 person of them had metabolic syndrome. Based on the definition, these people were those who at least had three of the following factors abnormally: HTN, FBS, TG, HDL and WC. Also hypertension was considered for all groups. Data was analyzed using Chi square test and Odds ratio.Results: The prevalence of metabolic syndrome was 0.6% to 7.5% in central areas of Iran. The most prevalent of metabolic syndrome was in hypertensive women with high TG and WC and the least prevalent was in hypertensive men with these two phenotypes: I-high FBS and WC, and 2-high FBS and low HDL (p<0.05). Overall prevalence of metabolic syndrome in hypertensive people in the most of urban population was more than rural population.Conclusion: Results showed that hypertension is associated with different metabolic syndromes, especially in women with central obesity and dyslipidemia which necessitates more attention in preventing and treatment of the disease in this high risk group.

Introduction: The use of complementary and alternative therapy is increasing and touch is one of them but several studies have indicated that premature neonates hospitalized in neonatal intensive care unit receive very little touch. The purpose of this research was to determine the effect of touch on arterial blood oxygen saturation in neonates with respiratory distress syndrome.Materials and Methods: This is a clinical trial with repeated measures that was performed on 37 neonates with respiratory distress syndrome. An information record form was used for data collection. The information record form was consisted of two parts: demographic information and a table for recording oxygen saturations. Oxygen saturation was measured by Nelkor pulse oxy meter. Information was collected in 3 sequential days. Arterial blood oxygen saturation was controlled 5 minutes before touch, then samples undergone 5 minutes touch and then in 5 and 15 minute intervals arterial blood oxygen saturation was controlled again. Data was analyzed using repeated measure ANOVA.Results: Findings showed that in the first day, arterial blood oxygen saturation in 5 minutes before, and 5 and 15 minutes after touch were 95/67, 95/91, 96 respectively. In second day, arterial blood and oxygen saturation in 5 minutes before, and 5 and 15 minutes after touch were 95/72, 96/05, 96/08 respectively. In third day, arterial blood oxygen saturation in 5 minutes before, and 5 and 15 minutes after touch were 95/75, 96/16, 96/13 respectively. Arterial blood oxygen saturation in 5 and 15 minutes after touch were more than 5 minutes before touch in each 3 day(p<0.01). But there was no significant difference between 5 and 15 minutes after touch. Data analysis also showed no significant difference comparing arterial blood oxygen saturation in the 3 days.Conclusion: Findings suggested that premature neonates physiologically responded to touch. Nurses working in NICUs must be educated about the importance of touch in providing care for these neonates. Findings showed that touch is useful for premature neonates and this fact can be a start point for other investigations.

Introduction: Life expectancy is one of the summary measures of population health, whose values and trend of changes over time show the main outcome of health system performance. Estimation of life expectancy is performed with direct or model-based methods. In this study direct estimation of life expectancy for Iran's population in year 2003 is performed.Materials and Methods: In an ecologic study, for calculation of abridged period life table for 23 out of 28 provinces of Iran in year 2003, numbers of registered deaths for age and sex specific groups in these 23 provinces by death registration system of Ministry of Health (MOH) were used. Undernumeration of over-four year's deaths was estimated and corrected with Brass Growth-Balance method. For mortality rates of under-one and 1-4 years, similar rates from Demographic and Health Survey (DHS) 2000 with live births denominators were substituted. For total number of population of 23 provinces, information from MOH was used. Distribution of population by age and sex was taken similar to that from DHS 2003 results, and also taken as result of graduation of whole country population from 1375 census. Population of these 23 provinces was equal to 73% of total population of country in year 2003. Life expectancy was estimated by age and sex with the obtained population and death numbers. It was assumed that distributions of population and death in 23 provinces were similar to those for the whole 28 provinces of Iran in year 2003 and hence, the estimated life expectancy for 23 provinces is equal to that for all 28 provinces in 2003. Sensitivity of the results to assumptions was analyzed. Confidence intervals were calculated with Monte Carlo method.Results: Life expectancy at birth was estimated as 71.56 years for total population (95% CI: 71.52 -71.62), 70.09 years for males (70.02 -70.16), and 73.17 (73.10 -73.24) for females of Iran in year 2003. Sensitivity of results to assumptions was less than 0.5%.Conclusion: Values of life expectancy estimates for year 2003 with direct method are higher than those based on statistical modeling approaches performed by Statistical Center of Iran and by different United Nations agencies, due to difference in estimation methods for age and sex specific mortality rates. 

Introduction: The objective of this study is to clarify the opinions of scientific board members of Sina university hospital about medical research and the ways of promoting these researches.Materials and Methods: This is a grounded theory study in which we used in-depth interviews and focus group discussions. Scientific board members and different authorities of the hospital such as the chief of hospital and the deputy of education were participated in the study. We used three different FGDs. Each group included about 5 people. We also interviewed the chief, the deputy of education and the head of clinical research center of the hospital.Results: Most of the participants in our FGDs believed that the most important factor for research promotion in the hospital was preparation of a data base of patients. They also mentioned that, different research workshops are important for empowering scientific board members in research.Conclusion: According to our study the most important strategies for research promotion in Sina hospital are data bank preparation, providing repeated research workshops, revising the bureaucratic process of proposal approvals, revising the manner of evaluation of scientific board members and more participation of the department of epidemiology in clinical researches.

Introduction: While elderly people enter the hospital in biological crisis, family caregivers enter the hospital in psychological crisis. But professional caregivers haven't adequate knowledge of family caregivers' experiences. Therefore they forget that family caregivers are in suffering equally. Since suffering is a significant concept in nursing science; and knowing and comprehending sources of suffering in family caregivers by professional caregivers is very important, this study is done to describe the nature and structure of sources of suffering in family caregivers of hospitalized elderly patients.Materials and Methods: This is a qualitative study with phenomenological method. Population of the research is all elderly patients' families that were hospitalized in one of the hospitals of Isfahan University of medical sciences.Sampling method was purposive and continued until data saturation. The numbers of participants are 12. Data were gathered through in-dept interview and data analysis done by "Parse" method that was not used in Iran.Results: The finding of this research is summarized in these core concepts: Patients and therapeutic interventions as source of suffering, hospital as source of suffering, disturbance in family and social life as source of suffering, self neglect as source of suffering. These concepts will be discussed in the full article.Conclusion: Participants' experiences reflect the need for planning interventions such as developing supportive groups, providing facility and instruments and continuous support for family caregivers during hospital stay. Also results show that educational programs are necessary for effective adaptation in family caregivers.

Introduction: About 21 millions low birth weight infants are born throughout the world and have less surviving chance compared to death rate of infants due to other causes. The aim of this study is to determine the relation of mothers' nutrient intake in the last trimester with the delivery of low birth weight infants.Materials and Methods: This Cohort study with a 3-months follow up was carried out on all the pregnant mothers visiting health care centers in Shahrood during their third trimester.Simple sampling was done and samples included 424 subjects. One-week food record of subjects was documented; biochemical and hematological tests and also anthropometric examinations were done, and demographic data were gathered. The infants' birth weight was measured after delivery. Data was gathered by a questionnaire and analyzed using Chi square, Mann- Whitney and Leven tests and logistic regression.Results: Total number of 424 pregnant mothers was studied in accordance with their amount of energy and protein intakes, and was classified in two groups of adequate and inadequate status. It was disclosed that 75% of mothers received low energy (less than 2500 k cal) and 20% were low in protein intake (less than 60gr). Low birth weight prevalence was detected to be 13%. Among low birth weight infants; 14%, 25% and 43% were attributed to mothers with low energy, low protein, and non-iron tablets intake respectively. There was a significant relationship between birth weight and iron supplementation (P=0.015), as well as multi-vitamins (P=0.048) during the last trimester of pregnancy. It was also disclosed that the probability of low birth weight infants among low weight mothers was 86%.Conclusion: According to the results there is a significant relationship between mother's nutritional status in the last trimester of pregnancy and infant's birth weight, so it is recommended that mother's weight gain especially in the third trimester and using adequate supplementations be considered.

Introduction: End stage renal disease (ESRD) is a major health problem and each year the number of patients is increasing. If the disease becomes irreversible, patients must always be hemodialyzed. Since mortality rate will increase due to inadequate dialysis, determining the efficacy of hemodialysis and improving its quality is very important. The main goal of this research is investigating the efficiency of hemodialysis.Materials and Methods: This is a cross-sectional analytical study which was conducted on 103 people who were under dialysis treatment in the Vali-e-Asr hospital of Arak in year 2003. Weight, blood pressure (before and after dialyze), time of dialysis, BUN and Cr before dialysis and 5 minutes after turning of the pump and before the second dialysis were measured. Data was analyzed by T test and Pears on correlation.Results: The mean of KTN was 0.58±0.1; normal protein catabolic rate (nPCR), 0.36±0.11 g/kg per day and time average concentration of urea (TAC), 43.3±14 mg/d; which had a significant difference with standard measures (p<0.05). KTIV was 0.49±0.18 and 0.47±0.10 for men and women respectively which was significantly different (p<0.03). There was a positive and linear relationship between education level and TAC, KTIV and number of dialysis per week.Conclusion: Regarding the low efficiency of hemodialysis in 80% of patients and lower levels of hemodialysis efficacy indicators in comparison to standard measures, periodic assessment and also investigating the reasons of low efficacy of hemodialysis is recommended.

Introduction: Secondary hyperparathyroidism (SHPT) is one of the serious complications in patients with chronic kidney disease (CKD). This study aimed to identify biochemical alterations of renal bone disease in hemodialysis patients of Qazvin province.Materials and Methods: In a descriptive study, fasting blood samples of arterio-venul shunt, before starting hemodialysis, were taken from all CKD patients and Ca++, P- and ALP were measured by colorimetric methods and PTH by IRMA method. Descriptive statistics was used to present data.Results: In 4% of cases there were no abnormalities of mentioned parameters but in 96% of patients one or more parameters were abnormal. The most prevalent abnormality was related to P-- (increased) and the least one to ALP (increased). 51% of patients had raised PTH level (hyperparathyroidism) and higher abnormalities of other biochemical parameters. No differences were seen in the mean of age, duration and number of hemodialysis and also sex ratio of hyperparathyroid patients and all studied patients. Conclusion: The Biochemical and hormonal results revealed a predominance of mild to moderate secondary hyperparathyroidism and renal bone disease in CKD patients, so there is a need to control the disease with specific treatments.

Introduction: World health organization has proclaimed the prevalence of smoking among 15 years old European region students, more than 24 percent. The cigarette smoking indicator in our country among over 15 years old individuals is 11.9 percent and in the province under survey is 15.6 percent. This research has been performed in order to study the effect of health education program based on health belief model (H.B.M) on preventive actions of smoking in middle school students.Materials and Methods: This is a quasi-experimental study, done on 248 students of grade one in middle schools of Boukan city (119 boys and 129 girls) that were randomly divided into experimental and control groups. Data collection tool was a questionnaire including 77 questions based on health belief model (perceived susceptibility, perceived severity, perceived benefits and perceived barriers to smoking, and cues to action) and preventive actions of. smoking. After data collection in the first stage, action was taken with regard to educational intervention and then in the second stage (after the intervention), data was collected again. Data was analyzed using T test. Results: Results showed that the mean score of all parts of health belief model in experimental group(except for perceived barriers) after educational intervention compared to before intervention was increased significantly and also the mean score of all parts of HBM after intervention was significantly increased in experimental group compared to control group.Conclusion: The results of this survey show that by increasing the score of health belief model parts; including, perceived susceptibility, perceived severity and perceived benefits, adopting preventive actions of smoking also increases. Therefore, the results of this survey confirm the efficiency of health belief model in adopting preventive actions of smoking.

Introduction: Nowadays, depression is one of the most prevalent psychological disorders and is a prevalent mood disorder. Recently researches about depression etiology, show that in addition to different neurotransmitters and life events, internal stressors such as serum cholesterol, triglyceride and some coagulation factors can have an effect. This study was focused on the relationship between major depressive disorder and serum cholesterol level.Materials and Methods: This research is a case control study that was performed in the year 2006. Case group were 62 patients referred to Hashemi Senejani psychiatric medical center and control group were chosen from ENT ward patients of Amir-Kabir hospital. Both groups were paired match for age, gender and education. In order to determine serum cholesterol level, 5cc blood sample was taken of each person from both groups. Data was analyzed using K-S and Mann-Witheny U tests.Results: The mean age of samples was 35.5±9.9 years. 77% were female, 67.2% married, 25.8% single and 6.5% divorced. Average serum cholesterol level in case group (215.6±47.6 mg/dl) in comparison to control group (183.1±31.2mg/dl) was significantly higher (p<0.05).Conclusion: Regarding the results, it seems that serum cholesterol is an internal stressor for depressive disorder so everyone with high serum cholesterol level must be evaluated for depressive disorder.

Introduction: Intra uterine device (IUD) is a highly effective contraceptive method but concerns about the risk of upper genital tract infection, often limits its use. Scientist believed that prophylactic antibiotic administration around the time of inserting IUD significantly reduces the risk of IUD related pelvic inflammatory disease (PID). This study is designed to investigate the effect of prophylactic antibiotic on pelvic inflammatory disease associated with IUD insertion.Materials and Methods: This is a randomized clinical trial. A total of 500 prospective IUD (TCU-380A) users were randomly assigned in two groups. The first group received 200 mg of Doxycycline one hour before IUD insertion and the second did not. Then, 20 days after IUD insertion, the two groups were examined for PID. Data was analyzed using Mann- Whitney and Chi square tests.Results: The mean of age, gravida, para, live children and abortion in case and control groups were not statistically significant. The rate of PID was 2.1% in case group compared to 1.9% in control group, which was not statistically significant. Vaginal infection in control group was more than case group but not significant.Conclusion: We concluded that the use of prophylactic antibiotic did not have a significant effect on preventing IUD induced PID. Regarding the side effects of unnecessary antibiotic consumption it is suggested to reinforce the need for implementing aseptic techniques during IUD insertion.

Introduction: The acute response to renal ischemia-reperfusion injury involves attenuation of glomerular filtration rate, as well as reduced tubular function. The possible mediators involved in ischemia-reperfusion injury include vasoconstrictor agents including angiotensin II (Ang II). fuhibition of the angiotensin II receptor type 1 (AT 1) diminishes the deleterious effects of ischemia-reperfusion on glomerular function. This study is done to investigate the effect of angiotensin II receptor type 1 antagonist on renal hemodynamic and tubular responses to ischemia-repetfusion injury in rat.Materials and Methods: ill this experimental study, acute renal failure was induced by 30 minutes clamping of both renal arteries in male Sprague-Dawley rats. Renal hemodynamic and excretory function was followed for 120 minutes reperfusion, while saline or the selective AT1 receptor antagonist (Losartan) was infused. In plasma and urine samples, Cr level was measured. Also plasma and urine content of Sodium was measured. Data was analyzed using ANOVA and Duncan tests.Results: Renal ischemia for 30 minutes decreased glomerular filtration rate during reperfusion and increased urine flow and Sodium excretion up to three fold. Losartan (10 mg/kg i.v.) did not change glomerular filtration rate prior to ischemiabut improved it during reperfusion and there were progressive increases in urine flow. Losartan caused a lowering of ischemia induced rise in Sodium excretion.Conclusion: The ischemic challenge may cause release of angiotensin II, which acts on AT1 receptors to decrease perfusion.

Introduction: Experimental autoimmune encephalomyelitis (EAE) is an animal model of multiple sclerosis distinguished by infiltration of leukocytes into the central nervous system.Changes in composition and levels of unsaturated fatty acids, affect the integrity of blood-brain barrier. In this study, we evaluated the effect of Sesame oil on the leukocyte infiltration into the brain of MOG35-55 induced EAE male C57BL/6 mice.Materials and Methods: In this experimental study, male C57BL/6 mice were placed in two therapeutic groups (n= 10 per group) with age and weight-matched as follow: 1.Sesame oil treated EAE mice received 4Ml/kg/day of Sesame oil given i.p. from day -3 until day +19 after disease induction, 2.Non-treated EAE mice (EAE control) received Phosphate buffer alone with same schedule. EAE was induced by immunization of mice with MOG35-55 peptide and complete Freund's adjuvant. Leukocytes infiltration into the brain was investigated 20 days after immunization. Data was analyzed using Mann-Whitney U test.Results: The results show that Sesame oil-treated mice had significantly less clinical score of EAE (2.6±0.4) than non-treated EAE induced mice (4.2±0.6), (p<0.001). Also, there was a significant difference at number of the infiltrating cells in brain between Sesame oil-treated (80±20) and non treated EAE-induced mice (150±30), (p<0.01).Conclusion: These results indicate that Sesame oil reduces infiltration of leukocytes into the brain of EAE mice, therefore lessening the histological changes and clinical signs and thus ameliorating the disease.

Introduction: Bronchogenic cysts are rare congenital lesions which originate from ventral foregut and most commonly originated in the central mediastinum. They rarely have symptoms and at the time of diagnosis they usually are large, infectious or complicated. In this study a case report of bronchogenic cyst is reported.Case: The patient to be presented is a 47 years old man with sudden onset of chest pain, severe dyspnea, tachypnea and decreasing right lung sounds. Symptoms of pneumotorax were observed in lung radiography. The patient was treated by inserting chest-tube, but there was no response to the treatment. Urgent thoracotomy was performed. A large single bronchogenic cyst was detected in the right lung parenchyma attached to intermediate bronchus. Complete resection was performed. According to the pathology report, pneumothorax was developed secondary to rupture of the bronchogenic cyst.Conclusion: Lung parenchyma is not a common area for developing bronchogenic cyst but it has special importance because of its severe complications. Since exact diagnosis is not always possible before surgery, it is necessary to perform resection in all suspicious cases.