JOURNAL OF ILAM UNIVERSITY OF MEDICAL SCIENCES
Year:2013 | Volume:21 | Issue:3|Papers Count:21

Introduction: The incidence of primary brain tumors is 18.1 per 100, 000. Evaluating the health related quality of life (HR-QOL) is considered as important issue amo-ng patients with brain tumors. The objective of this study was to examine the HRQOL and its associated factors among patients with primary brain tumors.Materials & Methods: For the descriptive analytical study, 194 patients with brain tumors who had referred to the hospital of Shariati in Tehran were selected according to the convenient sampling method. The eligible patients were asked to complete a questionnaire which consisted of demographic questions, clinical variables, the EORTC QLQ-C30 and The EORTC QLQBN20.Performance status and cognitive functioning were examinded using Karnofsky Performance Scale and the Mini-Mental State Exam, respectively.Findings: Mean age of the patients was 42.05±16.0 years. Most of the patients were male (53%) and married (66%). The multivariate regression models indicated that the older age, female gender and lower education were associated with the poor quality of life and more symptoms (P<0.001). On the other hand, combinational supportive treatments (radio-chemotherapy), total resection, better MMSE score, higher functional status were associated with higher quality of life (P<0.05). These results were similar for both the generic and disease specific quality of life. However, demographic and clinical variables were more suitable for the prediction of the changings of the disease related specific quality of life in compareison with the generic measures.Discussion & Conclusion: Acoording to the results of the study, the patients with brain tumor suffer from poor quality of life in all generic and specific dimensions. The need for supportive interventions including new treatment strategies, rehabilitation and social aiding in the patients is unequivocal.

Introduction: Health includes a spectrum of elements such as physical, psychological, moral, social, intellectual and environmental. Proper nutrition, enough physical activity, avoidance from dangerous behaviors and early diagnosis of ailments signs are all necessary to achieve the highest level of physical health. Moreover, health improvement will help populations through enhancement in their own health control.Considering this fact that about 50% of all expenses are due to unhealthy lifestyle, we decided to examine health promoting behaviors amongst academic staff of Yazd University of Medical Sciences.Materials & Methods: Totally, 142 teachers in Yazd Shahid Sadoqi University participated in this cross-sectional study through census method. Data were collected using an HpLp-II questionnaire which involved 52 items, 2 categories and 6 sub-scales. First category covered health promoting behaviors which included health responsibility, physical activity and nutritional habits subscale. Second category consisted of psychosocial well-being, which included components such as spiritual growth, interpersonal relations, and stress management subscale. Each question was valued considering likert scale ranging from 52 to 208. The collected data entered in SPSS and analyzed by statistical tests including X2, T-Test and Correlation.Findings: Results from 142 questionnaires showed that 26.8% of participants were female and the remaining, 73.2%, were male.6.3% of the participants were single and 93.7% were married. 51.4% of them were specialist. Results showed that the more participants evaluated their health as good, the more they got higher scores in health promoting behaviors. Comparison of two genders in health prompting behaviors group showed that female staff achieved higher score in nutritional behavior, health responsibility and interpersonal relations but the differrences were not statistically significant. Evaluating health prompting behaviors with considering marital status of participants showed that married acquired higher scores in physical activity and nutritional behavior in comparison with single participants, but these differences are not statically significant too. Only a few number of participants showed health responsibility (10.6% to 18.4%). Altogether, scores regarding physical activity in both genders were low in contrast with other measures of health promoting behaviors and only 18.24% to 28.8% of participants obeyed a scheduled physical activity program. Diet patterns showed that the portions of vegetable and whole grains in participants’ diet were below the recommended amount. Moreover, only 50% of subjects ate breakfast. Data regarding stress management showed that about 40% of participants used stress management skills and male subjects achieved higher scores in this area.Discussion & Conclusion: Results from this study showed that about 60% of participants achieved scores from health promoting behaveiors. The most obtained scores were related to spiritual growth and the weakest one were from physical activity. In other subscales the subjects showed an average manner. Considering this fact that an overall improvement in health promoting behaviors will increase academic staff activity, efficiency and productivity, we suggest using the theories of behavior change wich are useful as a foundation for developing interventions to promote health promoting behaviors in academic staffs.

Introduction: Given the ever-increasing growth of escaping of adolescents particularly girls from home and the individual and social unfavorable consequences of the event, this study was conducted to survey the personal and psychological features of the escaping of girls and women in Kermanshah Township during 2011.Materials & Methods: The present research was a quantitative study that was performed on 98 runaway girls and women in Kermanshah attending the Social Emergency Centre of information. The SCL-90 questionnaires were purposefully used to be completed by the subjects. The data drawn from this approach were analyzed by using of the descriptive and inferential statistical methods. The statistical tests used in this study were «mean» and c2.Findings: The findings of this study indicated a significant relationship between escaping and depression (71.42), aggressiveness (67.33), protection problems in mutual relationships (60.19), morbid anxiety (57.13), paranoid disorder (38.76), psychotic disorders (38.76), hypochondriasis disorder (37.74), obsessive-compulsive disorder (32.46), and phobias (31.62) among the subjects under study (P<0.05).Discussion & Conclusion: Considering the increasing trend of girls’ escaping from home and its unfavorable consequences, paying attention to the preventative measures, identification of predisposing factors and various interventional rectifying actions may be necessary.

Introduction: Pain is one of the most problems after cesarean section that causes many physiological and psychological problems for mother. Numerous actions have been used to alleviate the post operative pain of cesarean. However, there is no consensus about the best suitable analgesic method. Aim of this study was to compare the impacts of general and spinal anesthesia on the severity of pain and consequences of the cesarean operation.Materials & Methods: The present research was a double-blinded, randomized, clinical trial study, in which 110 pregnant women aged 20-35 years undergoing cesarean (55 women in the spinal group and 55 women in the general group) were assessed. Surgery technique was the same in both groups. All women received diclofenac sodium as suppository. The post operation pain intensity (intolerable, sever, moderate, mild and no pain) were measured in groups by visual analog scale (VAS), headache, nausea and vomiting frequency. Also, the analgesic dose were measured in two groups then compared. The data was analyzed by the SPSS software, version 11 and the statistical tests, chi-square and fisher.Finding: 17.3% of the participants had nausea and vomiting and 2.7% had headache after cesarean operation. In the recovery room before receiving the analgesics, 44.5% had moderate pain, and after receiving of analgesics 59.1% had mild pain.47.3% of the patients received two doses of diclofenac sodium for relief of pain. There was a significant relationship between anesthesia type and pain intensity after surgery (p<0.05). There was no significant relationship between the anesthesia type and headache after pain.Discussion & Conclusion: The type of anesthesia has a significant influence on the intensity of pain, headache, nausea, and vomiting after cesarean section.

Introduction: Morphine is a potent analgesic and narcotic drug that is found in opium. It is also an endocrine substance in humans and animals. This medication is used to treat mild to severe pain. This study was done to evaluate the histopathological effects of opium on liver and kidney.Materials & Methods: 60 rabbits (30 male and 30 female) weighing 300-250 g were divided into the control and addicts groups, randomly. Addicted rabbits received 25 mg/ case/day opium by gavage. The dosages were gradually increased to 100 mg/case/ day over a period of one week and kept on to day 60. At the end of the period, rabbits were euthanized, their kidney and liver tissues were removed and fixed in formalin. Routine histological and H& E staining methods were applied to prepare microscopic slides.Findings: In the rabbits treated with opium, dilation of collecting tubules, dilation of interestisial tissue along with sever perfusion, hypertrophy and hyperplasia of renal corpuscles and degeneration of urinary tubules were evidence. In liver, hyperemia in central veins, diffusion of inflammatory cells, fatty droplet accumulation, necrosis of hepatocytes and enlargement of the sinusoids were observed.Discussion & Conclusion: Morphine caused structural abnormalities in liver and kidney. With respect to our findings, the histological changes and dysfunction in the kidney and liver should be considered as serious consequences of opium addiction.

Introduction: Rodents are potential reservoir of many zoonotic diseases including several helminthic infections. Identification of these parasitic agents in different parts of the country is worth mentioning.Materials & Methods: For the study, during 2010-2011, 108 rats were collected using live traps in Dezfoul and Andimeshk, north of Khuzestan province of Iran. The rats were individually dissected and their recovered worms were taxonomically identified.Findings: Amongst 108 captured rats, 38 rats were found infected with parasitic worms. Prevalence rate for all parasitic helminths were estimated 35.1% and mixed infections were seen in 6 rats. From the 38 infected rats, six mixed infections were assigned. Identified helminths were as follows: Trichosomoides crassicauda (13.8%), Hymenolepis diminuta (10.1%), Cystycer cus fasciolaris (7.4%), Richtolaria ratti (2.7%), Moniliformis moniliformis (2.7%), Hymenolepis nana (1.8%) and Nippostrongylus brasiliensis (1.8%).Discussion & Conclusion: Our results revealed the presence of five species including, H.nana, H.diminuta, M.moniliformis, Richtolaria ratti and C.fasciolaris as parasitic zoonoses that are considered as infectious helminths of human according to scientific literature. The first three parasites are among the likely prevalent helminths, whereas the latest two worms are considered as very rare parasitic infection in humans.

Introduction: Annually, about one million persons attempt to suicide and averagely, one person suicides in every forty seconds. According to the world official statistics about one-third (27%-37%) of the suicides are caused by self-burning. In accords with the reports of deaths registration system in Iran, eleven people daily die because of suicide and one-third of them end their life by self-burning.The aim of the study was to evaluate the percentages of burning in subjects who committed to self-burning in the province of Ilam between 1372-1385.Materials & Methods: In the cross-sectional study all documents of patients with the history of burning were separated at the hospital of Taleghani in the province of Ilam during 1372-1385. About 587 cases of the patients had committed to burn themselves. Then, some information such as age, sex, level of education, marital status, percentage of burning and etc were recorded in a standard questionnaire. Data were analyzed by Chi-square test, regression models and analysis of variance (ANOVA).Findings: Eighty percent of the patients were female with a mean age of 26. With the elevation of each year of age, the rate of suicide by burning was increased by 0.13%. The rate of mortality in subjects who committed to self-burning was 73% and the mean percentage of their burning was 82%. The majority of the patients were married and unemployed with low level of education. 86.67% and 75.9% of the patients had a history of physical illness and educational problems, respectively. Psychotic disorders were detected among 74.73% of the cases. The rate of self-burning was 82% among subjects who had graduated from high school. Most of the suicides by burning had been occurred in winter and to lesser extent in summer.Discussion & Conclusion: Self-burning is the most common method of suicide in the province of Ilam, Iran. Although, the most of risk factors for suicide in our study were similar to those that have been known in the literature, we found that the high risk groups were married women and the most important risk factors of self-burning included, physical illness, education problem, unemployment, psychotic problem and other social factors. The findings of the study could be helpful and may offer strategies to decrease the rate of suicide in the province of Ilam.

Introduction: Sand flies are insects from the order of diptera that transmit a variety of diseases, such as all type of leishmaniasis, sand fly fever and bartonellosis. The diseases are transmitted by the infected female sand flies. The knowledge on the ecology of sand flies has an essential role to restrain the cutaneous leishmaniasis (CL). The study was carried out to determine the fauna and monthly activity of sand flies at cutaneous leishmaniasis focus in Ghanavat district of Qom province during 2012.Materials & Methods: The present research was a cross-sectional study that was conducted on sand flies in Ghanavat district of Qom province during 2012. Sand flies were collected biweekly from indoors and outdoors (rodent burrows) of three villages, using 180 sticky traps from the beginning of May to the end of November of the active season. For species identification, sand flies were identified using the valid keys. Then, their fauna and seasonal activity were also determined.Findings: A total of 5940 sand flies (2079 from indoors and 3861 from outdoors) were collected and identified. Seven species, including three species of the genus phlebotomus (Phlebotomus papatasi, P. sergenti, P. caucasicus) and 4 species of the genus Sergentomyia (S. sintoni, S. dentate, S. clydei, S. pawlowski) were identified. The most common sand flies in indoors resting places were P. papatasi (81.6%). Two active peaks of the sand flies were observed in late of May and late of August.Discussion & Conclusion: sand flies peak activity in this area was the early of June and the late of August. P. papatasi was the dominant species in indoors and outdoors areas. It seems this species could be the potential vector for CL in the region under study.

Introduction: Biological characteristics of parents (height, age, nutrition, history of disease, drugs and substances abuse, blood groups and duration of pregnancy) have a fundamental role in the birth of disabled children. This study aimed to compare the boilogical characteristics between parents with more than one exceptional child and those parents with more than one normal child in the urban and rural region of Kermanshah province.Materials & Methods: In this causal- comparative research, 800 parents (400 parents with more than one exceptional child and 400 parents with more than one normal child) were selected by a random and multistage sampling method and completed an appropriate checklist (Afrooz, 2008). After collectingdata, they were analyzed using SPSS software the statistical tests, t-test, chi square.Findings: The finding indicated that there were significant differences in father's age, mother's age, mother's age at marriage, duration of pregnancy, good nutrition, and history of disease, drugs and substances abuse, blood groups between the two groups under study (P<0.01). However, there were no significant differences in mother's age at birth of child and mother's height between the two groups (P<0.01).Discussion & Conclusion: The results showed that there are significant differences between biological characteristics of the parents with more than one exceptional child and the biological characteristics of parents with more than one normal child. Therefore, with studying biological variables, researchers would be able to prevent the birth of disabled children and finally improve the physical and psychological health of the society.

Introduction: The increase of stress following the technological improvements appears to be an important factor that causes organs disorders. The present study was conducted to investigate the effects of chronic stress on the testes of Wistar rats.Materials & Methods: 18 Wistar rats were divided randomly into two equal groups. The animals under stress were exposed to differrent multiple stress such as forced swimming, restraint, water deprivation, isolation and food deprivation for 10 days while the animals in control group were kept in their cages without any stress. After the stress time, all animals were anesthesized and their testes were removed and weighed. After preparing microscopic slides and staining with Hematoxiline and Eosin, the number of spermatogonia, spermaticytes, sperm/leydig cells, and thickness of the seminiferous tubule were determined using Image Tool software in the studied groups. Finally the data were compared statistically.Finding: The present study showed that the mean number of spermatogonia, spermatocytes, sperm and leydig cells in the stress group were significantly decreased compared to the control group (P<0.001). Moreover, the mean thickness of seminiferous tubule in the stress group was significantly decreased compared to the control group.(P<0.001) Discussion & Conclusion: Our study showed that chronic multiple stress could have negative effects on rat testis by reducing the number of spermatogonia, spermatocytes, sperm, leydig cells and thickness of seminiferous tubule but more studies are needed to confirm these results.

Introduction: Cardiomyopathies are referred to those diseases accompanied with hearth dysfunction which the most common of them is dilated cardiomyopathy. This study aimed to evaluate the clinical symptom, prognosis, complications, treatment and mortality in patients with cardiomyopathy over a 10 years period.Materials & Methods: In this retrospective descriptive study, all patients had been discharged with the final diagnosis of dilated cardiomyopathy and referred to the Rajaee Hospital in Tehran, Iran during the past 10 years were studied. The necessary data of each patient was individually collected. Data analysis was performed using descriptive and inferential statistical tests.Findings: From 87 patients in the study, 54 (54%) and 40 (46%) patients were female and male, respectively. The most common reason of referring to the Hospital was dyspnea (70%) and the most common clinical finding was systolic murmur 3.6 in the left corner of sternum. The blood group of most patients was B+. There were a big heart in the radiography of chest, left ventricular dilatation in echocardiography, reduced left ventricle contractility in catheterization (EF=35%). The most common complications in the patients were mitral valve regurgitation and left heart failure. The embolism was reported as a rare complication. In evaluation of the relationship between prescribed medications and prognosis, the digitalis compounds, Lasix and Aldacton (with 2 died patients), were the most prescribed medications. The three above drugs along with Hydralazine had been led to the death of 1 patient.Discussion & Conclusion: According to the results of the study, it is appeared that the type of blood group may predispose subjects to dilated cardiomyopathy. Overcrowded environment and air pollution may increase the incidence of the disease the prescribed medications may influence the prongosis and mortality of the diseases.

Introduction: Stroke is the third cause of death in the world. Ischemic stroke can be observed in the 85 to 90% of strokes. In the condition, cerebral blood flow due to the blockage of blood vessels is interrupted and a very complex process, literally called the cascade of ischemic, begins to occur at the cellular and tissue level, which eventually leads to tissue damage and the expression of ischemic stroke. Approaches in this area are weak and a further knowledge of the molecular mechanisms contributing to more effective diagnosis and treatment. Of the valuable tools for the understanding of molecular processes involved in ischemic stroke is proteomics method that provides us a snapshot of the proteins expressed at the cellular or tissue level, and can give us valuable information for the characterization of its biological processes.Materials & Methods: In this study, the data from human brain proteome changes in ischemic stroke using two-dimensional gel electrophoresis and mass spectrometry were analyzed by DAVID program. The lists of genes with altered protein expression were obtained from the article “the proteome of human brain after ischemic stroke”. Findings were analyzed by the DAVID bioinformatics software. The association between ischemic stroke genes and other diseases, stroke clustering of proteins based on biological processes and intra cellular sites and molecular functions of the genes was performed via "GO" database.Findings: Of 39 genes involved in ischemic stroke, totally four biological pathways chart were obtained which were associated with central nervous system diseases such as Parkinson, Alzheimer and Huntington. Most of the proteins were located in mitochondria and more significantly involved in the response to oxidative stress, apoptosis and necrosis processes.Discussion & Conclusion: The data from two-dimensional gel electrophoresis-based proteomics experiments are important for understanding of the processes that occur during ischemic stroke. Proteins identification may be used as treatment targets or as biological markers for diagnostic and prognostic purposes in the management of stroke.

Introduction: Nutritional assessment is an important method in public health for measuring health status of people in community. In this study, nutritional status of students residing in the dormitories of Shahid Beheshti University of Medical Science regarding food groups’ intake were determined.Materials & Methods: In this descriptive analytical survey, 658 students residing in the dormitories of Shahid Beheshti University of Medical Science were selected by clustering sampling method. Data were collected using a questionnaire and analyzed by the statistical software, SPSS version 16.Findings: Mean age of participants was 21.82 years for female and 22.76 years for male. Consumption of cereals (P=0.03), meat and its substitutes (P=0.000), fruits (P=0.003), vegetables (P=0.000) and other foods (P=0.000) was significantly more in female students compared to males.Discussion & Conclusion: Results of the research indicated that the students had optimal practice towards nutrition. Thus, more attention is necessary to be paid by authorities to this specific topic and some measures are essential in training students in order to maintain and continue optimal nutritional status.

Introduction: Chronic diarrhea is accompanied with abdominal symptoms and restricts the activity of patient. Precise evaluation of the history of patient, physical examination, laboratory and radiological evaluation, colonoscopy and biopsy may be helpful to determine the underlying causes of chronic diarrhea.Materials & Methods: For the study, 100 patients (50 male and 50 female) with chronic diarrhea were studied. These patients had referred to Tabriz Sina hospital, Iran during 2006 to 2011. The patients were examined for the presence of fecal leukocytes, parasitic eggs and trophozoites. Studding parameters such as colonoscopic findings and final diagnoses based on intestinal mucous biopsy were study. Data were analyzed by using of SPSS software and the statistical tests, frequency and chi-square.Findings: Mean age of men was 36.44 year and men age of women was 38.56 year. Colonoscopic findings were as 61% inflammation, 10% erosion and 29% normal. Biopsy study findings were as 59% nonspecific colitis, 15% ulcerative colitis and 26% amebic colitis.Discussion & Conclusion: Chronic diarrhea may be only one symptom of underlying digestive diseases. Therefore, after exclusion of infective and parasitological causes, invasive diagnostic method is indicated. The two method are together considered useful diagnostic tool for the management of the chronic disease and prevent the undesired economical and health problems for the patients.

Introduction: With increasing physical activity and energy expenditure based on various intensities and durations of exercise training in diabetic and non-diabetic individuals, the morbidity and complications of diabetes are decreased and hyperglycemia is desirably controlled. Is there a correlation between estimated maximum oxygen consumption (VO2max) and concentration of serum glycosylated hemoglobin (HbA1c) in active, sedentary and coronary artery disease (CAD) men. What is the possible range of the correlations? The aim of this cross-sectional study was to determine and compare the correlations between VO2max and concentration of HbA1c.Materials & Methods: The participant subjects comprised of three groups of active, sedentary and CAD men (40-55years) who were randomly and voluntarily selected for the study. VO2 max was estimated based on non-exercise prediction equation. Fasting blood levels of HbA1c were measured by an enzymatic immunoassay method. Correlations between estimated VO2max and HbA1c were determined via Spearman rank correlation coefficients. The statistical tests, T-Fisher and Z-Fisher, were applied for signification and comparison of them at the significant level of p£0.05 .Findings: The amount of analyzed parameters were as follow: VO2max (active: 39.039±2.563, sedentary: 32.647±3.056 and CAD: 30.375±4.275 mL.Kg-1.min-1), fasting blood HbA1c (active: 4.266±0.365, sedentary: 4.733±1.370 and CAD: 5.253±1.321 mg/dl). The correlation coefficient between VO2max and HbA1c was significant in CAD men (rs (13)=-0.538*, p=0.039) but were not significant in active (rs (13)=-0.291, p=0.292) and sedentary (rs (13)=-0.338, p=0.217) men .Discussion & Conclusion: According to the above results, it could be concluded that the physical activity has no any desirable effect on HbA1c and HbA1c is resistant to exercise training .

Introduction: Community based interventions for enhancing the generalization of the benefits of health programs, providing information for policymakers and improving the community health are more appropriate than the patient-centered clinical trials. The community-based approaches for preventing injuries are widely accepted but there is a little strong evidence of the effecttiveness of programs with multiple objectives in the community. Therefore current study aimed to review the community based interventions for preventing motor vehicle injuries.Materials & Methods: The research was a review study. Community-based interventions, injury, safe traffic behavior and seat belt were used as keywords in the databases, Science direct, Pubmed, Ovid, Oxford journals, EBS-CO and Cochrane to search systematic reviews. A total of 28 community-based interventions related articles on injuries were reviewed. The results of these articles were analyzed.Findings: The most of the studies were non-randomized controlled clinical trials (78.57%) and were mainly carried out in the USA (46.43%). The interventions were mainly as integrated approachs (60.71%).The primary outcomes of the studies were the use of helmet (35.72%), unintentional injuries (14.28%), high-risk driving behaviors (10.72%), use of child seat (7.14%), use of seat belt (10.72%) and safe traffic behaviors (21.42%) Discussion & Conclusion: In general, the integration of several strategies or the community-based interventions alone has a preventive effect on traffic injuries. We recommend a combination of multiple methods to prevent traffic injuries.

Introduction: Sarcoidosis is a chronic inflammatory pulmonary disease with unknown etiology and variable clinical manifestations including, epithelial cell granulomas and alteration in tissue and organ functions.Materials & Methods: In this cross-sectional study, high-resolution computed tomography (HRCT) documents of patients with proven sarcoidosis were reevaluated. The results were analyzed using the software SPSS-11 and frequencies of the disease were reported as percentages and diagrams.Findings: Many typical and atypical manifestations of sarcoidosis such as bronchiectasis, lymphadenopathy, lymph node calcification and etc, were observed at HRCT .Discussion & Conclusion: HRC may provide more advantages to identify and distinguish sarcoidosis from other mimicking diseases. However, further investigations are needed to scrutinize the matter.