مجله علوم پزشکی صدرا
سال ششم شماره 2 (بهار 1397)

Hemodialysis is a tense process and life events influence the treatment process of patients. The aim of this research was to determine the relation between metacognitive beliefs, life expectancy, and quality of life as three contributing factors and hospital depression in kidney patients undergoing hemodialysis in the city of Karaj.
The research method was correlative. Sampling was done based on 106 kidney patient volunteers undergoing hemodialysis in the year 1395. They all filled out the Metacognitive Beliefs Questionnaire (MCQ-30), Steiner-syndrome life expectancy questionnaire, kidney patients’ quality of life and the hospitalized patients’ depression questionnaires. Data analysis was carried out using SPSS and the regression analysis was performed simultaneously.
Metacognitive beliefs were uncontrollable, cognitive confidence was low, general negative beliefs regarding thoughts were positive, and positive cognitive beliefs and negative conscious cognition were able to significantly predict depression in the hospitalized patients (P Hospital depression affects hemodialysis patients’ physical and psychological factors. Thus it is recommended that their condition is periodically examined and pharmacological or non-pharmacological procedures are applied accordingly.

E. coli is one of the prevalent factors in human infections, especially urinary tract infections. Extended-spectrum ß-lactamase (ESBL) producing bacteria causes resistance to cephalosporin. Furthermore, the enzyme with the origin of plasmid causes the bacterial resistance to beta-lactam antibiotics. The aim of this study was to determine antibiotic susceptibility patterns and prevalence of CTX-M-type ESBL in E. coli strains isolated from urine samples by phenotypic and genotypic methods.
This descriptive, cross-sectional study of six-month duration (from December to April 2016) was undertaken to investigate patients’ antibiotic susceptibility. To fulfill that purpose, the urine samples of patients referred to seven clinics of the armed forces of the Mazandaran province were collected and antibiotic susceptibility of isolates by disk diffusion method on Mueller-Hinton agar was tested. To do confirmatory tests, the combined disk test method was performed. The test results were compared using standards Clinical and Laboratory standards (CLSIS). Ultimately, after DNA extraction by PCR method, isolates of ESBL positive for the presence of the CTX-M gene were examined and data were analyzed with SPSS software.
Of the total 180 patients, 41 isolates of Escherichia coli were separated. From those, 21 isolates (51.21%) had produced ESBL. In PCR, 4(9.75%) of the ESBL positive isolates contained CTX-M gene. The highest resistance to antibiotics was observed for ampicillin (75.6%), cefalotin (58.5%), and cefazolin (60.9%) and the highest amount of sensitivity to antibiotics was seen for imipenem (75.6%), gentamicin (70.7%), and cefotaxime (60.9%).
Based on the observed high percentage of resistance to the third-generation-sfalspvryn, it is vitally important to perform precise and accurate antibiogram. Avoiding excessive over-prescription of antibiotics for infections caused by ESBL-producing organism is an inevitable necessity.

Informal payments are out-of-pocket payments that are paid to health care providers for services that must be provided to patients with no cost. These services can be in various forms including cash or non-cash contributions and presents. Since the informal payments have a significant effect on the health care system in terms of equity, access, and efficiency, the aim of this study was to estimate the amount and frequency of informal payments in patients referring to the Isfahan hospitals.
This study was a cross-sectional study which was carried out during the last six months of 2015 in 10 hospitals of Isfahan. 250 patients were randomly selected and their demographic profile consisted of gender, age, type of insurance, payment amount, type of treatment, hospital, etc. To collect the data regarding the amount of informal payment obtained by health care providers, questionnaires and telephone interviews were adopted and data analysis was carried out using SPSS 19 software.
Results of the study showed that 27.2 % of patients had informal payments. The average informal payment made to doctors was 590,000 Tomans, to nurses was 23,500 Tomans and to other staff was 14,500 Tomans per patient. With informal payments compared to non- informal payments, the results revealed there was significant statistical differences (P This study revealed the amount, frequency and variables that contributed to patients’ informal payments. Considering the negative consequences of informal payments, it is recommended that by controlling and studying the influential variables as well as paying enough attention to the amount of these payments in different groups, these payments can be detected and prevented.

Aging is accompanied by a reduction in physical and psychological health, disability, and social isolation, which causes hopelessness in the elderly. Life expectancy can strengthen the motivation for moving towards desirable goals. Religious coping, by adopting cognitive and behavioral strategies, helps individuals to manage emotional tension and physical discomfort. The aim of this study was to determine the relationship between negative and positive religious coping and level of hope among the elderly referring to the elderly day centers in Shiraz.
This cross-sectional correlation study was performed on 200 elderly people who had been referred to the elderly day centers in Shiraz-Iran. The participants were selected through convenience sampling method. The data collection tool included demographic data questionnaire, Hope questionnaire, and a short questionnaire for religious coping. Data were analyzed by SPSS software version 19 using descriptive and analytic statistics including independent t-test, one-way ANOVA, Pearson correlation coefficient, and linear regression test.
The mean score of hope was 48.7 with a standard deviation of 8.23 which indicated moderate level of hope in the studied subjects. Results also showed a significant correlation between positive religious coping (r = 0.403, p Considering the role of positive religious coping strategies in promoting hope, it is better to pay more attention to this subject in future planning.

Ischemic heart diseases have been the world’s leading causes of death during the past decade. Accordingly, this study investigated the effects of three selected exercise training programs on some cardiovascular risk factors in adolescent soccer players.
A total of 48 adolescent soccer players were enrolled in this study (age 13.46±0.74 years) and were divided into four groups (n=12). Group A alternatively performed an endurance training, strength training and sprint in 15 training sessions. Group B underwent endurance training for the first 5 sessions, strength training for the next five consecutive sessions and sprint training for the last five sessions. Group C was given all three factors of endurance, strength, and speed during the fifteen sessions of exercise within one session. Group D (control group) continued with their daily football routines. Demographic variables such as weight, body fat percentage, body mass index, total cholesterol (TC), Triglyceride (TG), High Density Lipoprotein (HDL) levels and Low Density Lipoprotein (LDL) were measured in these adolescents. Data were entered into SPSS 18 statistical software and were analyzed by descriptive statistics and ANOVA test.
In the post-test, the levels of TC, TG and HDL changed significantly in Group C in comparison with the pre-test (P Many serious diseases in adulthood have their origins in adolescence and the result of the present study indicated that three type exercise training programs resulted in enhancing some of the metabolic factors related to cardiovascular risk in the adolescent football players; however, it is worth mentioning that each type of training can have unique benefits.

Patient medication adherence refers to the timely and correct use of medications prescribed by the physician. The aim of this study was to determine the adherence rate of antihypertensive drugs in heart disease patients referring to the Imam Reza Clinic in Shiraz, Iran.
This cross-sectional study was performed on 282 heart disease patients, who used antihypertensive, referring to Imam Reza (AS) clinic in Shiraz in 1396. For data collection, a demographic questionnaire and a Morisky Medication Adherence Scale, which was valid for the Iranian community, were used. Data were analyzed using SPSS software.
The results of this study revealed that the antihypertensive drug adherence in 95 heart disease patients (76%) was low. However, 16% and 7% of the patients reported moderate and high adherence to antihypertensive drugs, respectively. The most common causes of patients’ antihypertensive drug non-adherence were forgetting to take the medication (76.2 %), irregular taking of the medication while traveling (63.8) or while leaving the house, and being tired as a result of daily and continually taking the drugs (58.5 %). Moreover, the results showed that by aging, the antihypertensive drug adherence decreased (r= - 0.22, P This study showed that more than two-thirds of heart disease patients had low medication adherence. The most common causes were missed medication and irregular travelling-related medication intake. Performing some strategies for solving this issue is recommended. Keywords: Medication adherence; Antihypertensive agents; Heart diseases.