مجله دانشگاه علوم پزشکی ایلام
سال بیست و دوم شماره 2 (پیاپی 85، خرداد 1393)

Infectious diseases among ho-spitals are a major healthcare problem in the world. Some of these infections are cau-sed by ingestion of contaminated foods in the hospitals. The aim of this study was to investigate the role of hospital foods in the transmission of clinically important bacteria into the hospital environment. Frequency of the main bacterial pathogens responsible for h-ospital infections were studied among sam-ples from foods, food handlers and food p-rocessing devices. Swab culture and aerobic plate count assay were used for the isolation of suspected bacteria. Colony count of each culture and biochemical or molecular ident-ification of each isolate was determined according to standard methods. Antim-icrobial susceptibility of each bacterial iso-late was determined according to the latest clinical laboratory standard guideline. Among the 200 samples under study, the highest frequency of contam-ination (40%) was seen among utensils. Furthermore, Staphylococcus aureus show-ed the highest frequency (16%) among the obtained isolates, while Escherichia coli re-presented 8% of the contaminations. Fewer rates of contaminations were belonging to other responsible bacterial pathogens, inclu-ding Pseudomonas spp., Acinetbacter spp. and Enterococcus spp. (0-4.6%). Among the Staphylococcus aureus isolates, the mu-ltidrug resistance phenotypes were observed to be 18.7%. This phenotype was observed among 52.9% of Escherichia coli isolates but not among other isolates. Among the studied samples, the highest frequency of multidrug resistance was seen among uten-sils. Discussion & Outbreaks of food borne disease has been reported in ho-spitals. High frequency of clinically imp-ortant bacteria among utensils compared with samples of foods or food staffs, and the presence of enteric or skin marker bac-teria in these samples revealed the possible role of hospital foods as a risk factor for dissemination of pathogenic bacteria into hospital environment.

Nowadays, excessive pop ulation growths, urbanization, and cons-umption of fossil fuel lead to the envi-ronmental pollution and damages. So, there is a significant attention to the usi-ng of cleaner fuels such as biogas. Man-y countries use biomass in order to pro-duce biogas as a source of energy. But in Iran, biomass usage has not been yet taken into account. It may be due to the lack ofthe biogas technology and cost. This study aimed to introduce a new ty-pe of semi-automatic green biogas ma-chinewith high efficiencyand enhance its output. In our machine, new mechanical and electronic parts de-vised and economically made. These parts were included: 1- electronic senso-rand monitoringpartfor temperature, hu- midity and methane variables, 2- seven-layer flexible gas tank, and 3- electronic safety valve with controllable gage for escaping excessive gas. The results of the experime-ntal usage of machine showed that the extent of produced gas was acceptable, saf-e, manageable and economic. Discussion & We could im-prove its efficiency throughcontrolling and changing differentvariablesin trial and error manner. So, useful results ob-tained from this machine showed that this device can be used to enhance the efficiency of methane production by 25 %.

Thalassemia is the most common autosomal recessive disease in the world. HBB gene mutations cause the disease. The high rate of consanguineous marriages in our country can be one of the factors that increases the incidence of this disease. The aim of this study was to determine the beta-globin gene mutations in the city of Ilam. hematologic parameters of patients referred to health centers of Ilam city during 87-91 years, were evaluated for the presence of thalassemia trait, then, the suspected couples were investigated for HBB gene mutations. the following mutations IVSII-1, IVSI-5, IVSI-6, CD36/37, Fr8-9 and CD82/83 were found. IVSII-1 mutation was more common than other mutations among the studied subjects. IVSII-1 mutation probably has occurred for the first time in Iranian population. Beta-thalassemia mutations vary among different ethnic groups of Iran. It is recommended that each ethnic and race to be studied separately.

Standards observation in imaging centers cause to patient dose reduction in patients and improving image quality. Identification standards and determine the gap own facilities with standard centers is a necessity for standardization. In this article, Standards level in imaging centers have been studied in Ilam province. Dose was measured in the controlled, monitored and uncontrolled region for each center. Czech list contains 210 items were prepared by using standard values in the world and Iran. Separately, Czech list were completed for each center. Level standard calculated at sections: building and construction, Preparation and usage of equipment, Protection of staff and patients, Patient rights and staff salaries for all hospitals and presented as percentage of standard. Level of patient information has been checked about radiation effects by using the questionnaire. Level of dose were standard in controlled monitored and uncontrolled region all of centers. Generally the level standards in Ilam imaging centers were obtained at sections: Building and construction 64.9 ℅, Preparation and usage of equipment 69.4℅, Protective staff and patients 80.03℅, Rights of patients 81.7℅ and staff rights almost 100%. Patient imaging centers were aware of effects of radiation on cell were 28%. In this study, the level of standard and distance to the full the level of standardization Were determined for all centers.The level of gap with completely standardization of imaging centers in the province is building and construction section35.1℅, preparing and application of equipment 30.6℅, Protection of staff and patients 19.97℅, Patient rights 18.3%. As well as patient imaging centers not informed about the effects of radiation on cells were 72%.

Almond as a traditional medicinal plant has been used as antidiabetic and hypoglycemic in some area of Iran. This study aimed to determine the effect of almond root extract and its effective compound 'amygdalin' on blood glucose level of diabetic rats. 48 NMRI male rats (180-250gr) divided to 2 groups; normal and diabetic, which included three saline, amygdalin (received i.p. injections of 100 mg/kg per day, for a weak) and extract (received oral gavages of 100 mg/kg almond root extract per day, for a weak) subgroups. Diabetes was induced by single injection of streptozotocine (60mg/kg, i.p.). Blood glucose of each sample was measured in 4, 8, 24 hour and one week after the last treatment, by using spectrophotometer, related kits and glucose oxidase method (absorption at a wavelength of 520 nm). Data were analyzed by using ANOVA, t-test and Dunnett. Treatment of diabetic rats with amygdalin or almond extract were decreased significantly blood glucose at 4 and 8 hours after prescription periods compare to saline group(P<0.0001). But there was no significant difference among these groups at 24 hour and one week timescales. Amygdalin and bitter almond extract can reduce blood glucose in diabetic rats.

Consideration of suicide attempt and related factors has valuable clinical outcomes in domains of prevention and crisis intervention. The purpose of this study was to investigate the predictive role of age, gender and psychological factors accompanied with suicide attempt in general population. In a cross-sectional descriptive study, 154 subjects included 43 persons with suicide attempts with drug poisoning that attended to the two poisoning referral hospitals in Tehran and 111 persons without suicide attempt among staffs in these hospitals were selected by convenience sampling. Data collected with NEO-Five Factor Personality Inventory, Symptom Check-List Revised, the defense Style Questionnaire, The Beck Scale for suicide Ideation, The Beck Hopelessness Scale and demographical questionnaire, then analyzed by T test and Logistic Regression with PASW. Suicide thoughts (OR=8/714; %CI:1/616-18/033), aggression (OR=5/006; %CI:1/829-16/115), psychoticism (OR=2/035; %CI:0/008-7/551), neuroticism (OR=4/991; %CI:1/704-9/417), extroversion (OR=2/818; %CI:1/014-8/965), neurotic defense style (OR=3/615; %CI:1/399-8/946), immature defense style (OR=2/215; %CI:1/008-7/466) and hopelessness (OR=8/922; %CI:1/834-21/058) significantly differentiated persons with suicide attempt from persons without suicide attempt (P<0/001). Discussion & In this model, risky psychological factors increase the odds ratio of suicide attempt. These finding have applied implications in designing of preventive interventions and crisis intervention programs for self-harm behaviors.

Introduction and The average age at menarche show regional variations, differs from country to country and various factor for example environmental condition and genetic factor influence for menarche age. this study performed to survey relationship between some anthropometric indices with Menarche age. This survey is cross sectional study. Study was conducted on 566 females student 8-15 years in 2013. participants were selected by random cluster sampling from 4 areas and 16 elementry and middle and high schools in Ahvaz city. the students who qualified for the study were enrolled. The data collection was based on interviews and measurement of height, weight and calculation of body mass index.collected data was encoded and was analyzed by spss software version 19 and Descriptive statistics (to determine the mean, standard deviation) and analytic statistics (Pearson correlation coefficient). The study subjects were 566 students aged 8-15. the mean age of menarche was 11.86±1.07 and Age at menarche correlated with height, weight and had an inverse association with body mass index. Based on these findings, There is correlation between anthropometric characters and age of menarche. Keywords: Height, Weight,Body Mass Index, Menarche

The World Health Organization defines mental health as communicate with others, improving the environment and conflict resolving. In recent years, the prevalence of mental disorders has increased and the prevalence of mental disorders has been reported to be 18-23% in Iran. This study is a descriptive- comparative research that the mental health of boys and girls in schools has been studied. The required information is obtained by means of the GHQ 28 standard questionnaire that is distributed among 118 students. The mental health is divided into four categories, the first category with 0-21 score, the second with 22-42, the third with 43-63 and the latter group which received the scores of 64-84. The SPSS software was used for data analysis. The sample included 64 (54%) male and 54 (46%) female and the overall score of the students were classified into 4 categories. Among the samples, 38 students (32.2%), 61 students (51.7%), 17 students (14.7 %) and two persons (1.7%) are received the were received the scores of 0-21, 22-42, 43-63 and 64-84, respectively. Also, the statistical meaningful relationship is observed between the age, the grade and mental health (P <0.05). Relatively large numbers of children are of good mental health state. It is found that as age of participants is increased the mental health of children degraded. Students have a maturity period of less than mental health. Therefore, schools can make physical changes of puberty class advice on the mental health of students to increase during puberty.

Due to the importance of taking care of patients admitted to the treatment centers, especially ICU, the provided care should be commensurate with the severity of disease. Using APACHE II (Acute Physiology and Chronic Health Evaluation II) standard scoring for determining severity of the disease and comparing it with other therapeutic centers is necessary. The aim of this study was to determine the mortality rate of patients admitted to trauma ICU with different APACHE II scores. Methods and This descriptive and retrospective study was performed in 6 month period from March to Sep 2011 in trauma ICU ward of Shahid Beheshti Hospital of Qom. Overall admitted patients were 140 and data was obtained from 110 patients with complete data and special data sheet of APACHE II Scoring system was performed for them. Data sheet were prepared for all patient and at the end of sheet, total scoring was recorded. Out of 110 patients, 80 (73%) were male and 25(27%) were female. Mortality and viability in these two group was 25(22.7%) and 85(77.3%) respectively. Eight percent of 75 (68.2%) patients with scoring below 15 died and in 20(18.2%) patients with scoring 20-30, 12(60%) died and 8 patients survived. Of the patients with scoring number 16-19, mortality rate was 6(42.9%) and survival was 8 (57.1%). In comparison with standard scoring system, in our study mortality rate in scores below 19 was lower than standard, but with scores above 20, mortality rate was 25% higher than the standard system. APACHE II scoring system can be useful in trauma ICU and in greater scoring numbers, severe intensive care must be considered for ICU patient.

Gentamicin is an Aminoglycosid antibiotics that is clinically useful in the treatment of urinary tract infection, but an unwanted side effects on the physiological function of the kidneys can cause harmful effects that effects limits its use. Antioxidant compounds found in medicinal plants are good candidate for protecting against the damaging of gentamicin. In the present study for the first time, the protective effect of hydroalcholic extract of aerial parts Alhajy Mayrorum against gentamicin-induced nephrotoxicity in rats is evaluated. 28 male wistar rats in the weight range of 300±20g were randomly divided into 4 groups(n=7). All rats received the desired compounds in 8 days. In the last day blood samples were taken and serum concentrations of urea, uric acid, creatinine and BUN were measured. Gentamicin caused a significant increases in serum urea, uric acid, creatinine and BUN levels in blood rats under investigation and coadministration of gentamicin+plant extract was adjusted to baseline values. Discussion and Findings of this study showed that Alhajy Maurorum extract can effectively prevents side effects of the gentamicin on the kidneys. Probably Alhajy Maurorum extract can preventunwanted effects of gentamicin on urinary tract function recommended.

due to increasing development of electricity transmission in the country and non – compliance with privacy standard residential lines in some cities, many problems for the residents of these areas have been established. The aim of this study was to identify and assess risks in the area of power transmission lines by using William Fine method in hasyrabad and provide a solution is to reduce the effects. in order to determine the risks, processes and equipment required for power transmission through field visits and interviews with experts, are identified. Since the magnetic field emitted from the power lines as if it is illegal, can be considered as a risk, this parameter is measured in the study area based on the NIEHS standard with 3D EMF TESTER by four of the 91, 61, 30, 15 meters from the 230 kv tower, And eventually performed with the standard values can be compared. The identified risks by the parameters of William Fine method were scored and prioritization methodology was based on the placement table. Finally, to reduce the risk level, corrective control measures, were presented. measuring the magnetic field intensity in the study area, showed that field intensity at any desired distance from the most is above the permissible limit and can be considered as a risk. Finally, 41 risk in four categories: health, environmental, safety – technical and natural event by using William Fine method for 13 elements were identified. The highest risk to the wire and electrical transmission line with priority number 900 and minimum risk to the tower, wire guards, wire ground and span were obtained with a risk priority number 25. Discussion & according to the results, the highest levels of safety at risk – health RPN are 900 and 400 respectively that in most cases the cause of risk is non – compliance with privacy standards of electricity transmission lines in residential areas. so, the proposed control strategy to reduce the effects, compliance with the standards of offshore electricity transmission and prevent people from advancing and construction of urban space is provided for the risk.

Cadmium is dangerous due to the properties such as persistence and accumulation in the environment. The aim of study was the survey of cadmium ions removal in various conditions by nano zerovalent iron (nZVI) particles and manganese compounds. Absorbents were prepared according to used methods in literatures. After batch study of cadmium adsorption in synthetic solution by nZVI particles and manganese compounds (under various conditions of pH, concentration, and contact time), removal efficiency of cadmium from industrial wastewater sample was studied. The average size of the nanoparticles was 78 nm (by Dynamic Light Scattering analysis). Maximum Cadmium ion adsorption capacity from synthetic solution by nZVI particles in optimal conditions (pH = 7, the initial cadmium ions concentration= 20 mg/L, and contact time =60 min) was 58.1 mg/g, with hydrated manganese dioxide and the its composition with ferric hydroxide in optimal conditions (pH = 9, the initial cadmium ions concentration= 1 mg/L and contact time = 10 min) was 13.5 and 12.8 mg/g, respectively. Maximum efficiency of cadmium removal in the industrial wastewater by nZVI particles, hydrated manganese dioxide and its combine with ferric hydroxide were 91 %, 28 % and 27.8 % respectively. Discussion & Results showed that nZVI particle is more effective than manganese compounds in cadmium removal from synthetic solution and industrial wastewater with provide optimal conditions. Therefore it is more effective for removal of cadmium in contaminated aqueous environments.

The incidence of sharps injuries in Iran is high and therefore health care workers are at a higher risk for three major diseases, AIDS, hepatitis B and C, that are blood born diseases. This study aimed to investigate the promotional impact of educational intervention on behaviors of health care workers in Ilam province regading sharps injury prevention in 2012. In this quasi-experimental intervention study, 66 healthcare workers in health centers in the city of Dehloran (as the experimental group) and Abdanan (as the control group) were enrolled. The data were collected by a questionnaire completed by the participants, after the approval of its validity and reliability in two previous steps, and one month before the educational intervention. SPSS19 software was used to analyze the data using appropriate statistical methods. The mean difference between knowledge and attitude scores after the intervention in the experimental and control groups was significant. Number of injuries, a month before the intervention in both groups was five cases (15.15 %); while one month after the intervention it reduced to just one case (3.03 %) in the experimental group and four cases (12/12 %) in the control group. the design and implementation of an educational program for reducing injuries from sharps is beneficial. Keywords: Injuries caused by needles, training intervention, health care workers, prevention

The objects used by human are contamination by different kinds of microorganisms. Contaminated objects functions as sources of spreading diseases. As ATM banking machines are of the most common materials of everyday life, thus this study aims to determine bacterial contamination of bank ATM keyboards. in this cross-sectional study, 59 ATM banking machines in the city of Shahrekord were chosen by cluster sampling. Collecting data from ATM keyboards was conducted by sterile swab. Laboratory experiment method was used to determine type and amount of bacteria contamination. Then, the data was analyzed by spss16 software through T-Test, K2. The findings indicated that all the samples under study were positive regarding to the existence of pathogen bacteria and higher percentage of samples were polluted by the fecal bacteria. There was a significant relationship between the existence and lack of existence of plastic cover. (p< 0.001) Discussion and Due to the remarkable quantity of bacterial contamination on the ATM banking machines keyboards, training observing individual hygiene to the user via mass media or by sticking hygienic messages besides ATM can prevent from spreading some diseases. In addition, it is logical to remove plastic cover in that it increases contamination itself.

Oxacillin is commonly used in the treatment of beta-lactamase resistant staphylococci which causing several clinical infections. In vitro routine test for Oxacillin resistance may fail to detect due to presence of the mec(A) gene resulting in treatment failure. twenty seven staphylococci isolates were subjected to routine antibiotic susceptibility testing including Oxacilin (1µg) by kirby- bauer disk diffusion method. The Oxacillin resistance was detected by screen agar dilution (4% NaCl + ox 6 µg / ml in M.H.A/24 h /33-350c) and then with PCR for mec (A) gene. In total, 5 isolates (17/86%) were resistant to Oxacillin. Finally, two coagulase negative staphylococci isolates(7/14%) carried mec (A) genes. This study showed that handle of laryngoscope can be contaminated with resistant isolates. Considering the notable Oxacillin resistant these isolates cleaning and use of appropriate disinfectant is necessary to decrease the spread of them by laryngoscope in the special wards of hospital. Keywords: Laryngoscope, staphylococci, D-test

Uneven shoulder is one the most common musculoskeletal disorders among students which early diagnosis of this disorder may be treated with a modification of wrong patterns and corrective exercise. Therefore, the aim of this research was to assess uneven shoulder and its related factors among high school boys aged 15-18 years old in Ilam city. The present descriptive–survey research, performed in 2012-2013 on high school boys student aged 15-18 years in Ilam city. Among 3500 students, using Cochran method, 350 students have been assessed as our samples. A questionnaire has been used to obtain socio-demographic factors, and other information’s such as carry bags and other tools and handedness and the type of sport. Then, a Scoliometer and plummet has been used to measure the uneven shoulder and torticollis, respectively. Statistical analyses were performed with SPSS software. Chi-Square test, at significant level (P<0.05), was used to analyze the objectives of this study. Sixty-seven point two percent(67.2%) of our samples was diagnosed with uneven shoulder, this disorder was observed in the right and left side by 63.1% and 4.1%, respectively. Also, this research showed a significant relationship between uneven shoulder and handedness,carry bags and other tools, torticollis, ball sports and the sports which have been dealt with one side of the body. Disruption & In general, it can be concluded that over-using of one side pectoral girdle and a hand for exercise training, carry bags and other tools have played a significant role in uneven shoulder.

Addiction treatment and breaking the vicious cycle that is difficult and expensive. And want comprehensive treatment system with different approaches to drug therapy, psychotherapy and rehabilitation. In this study, was assessed the effects of methadone therapy on depression, anxiety and quality of life in addicts referred to addiction Treatment of Health Center of Shahid Ahmadi Tehran. This study was semi experimental that in 1389- 90 years was performed on addicts refer to addiction treatment center of ShahidAhmadi Tehran with available sampling method. Overall 96 people entered the study. The questionnaire consisted of 4 parts: Demographic information, Beck's depression inventory, STAI anxiety and quality of life, was complete before the start of treatment with methadone and one month after of treatment with methadone. Data were analyzed by using spss16 and paired t-test and wilcoxon. The results showed that 72 addict, were depressed before the treatment with methadone. One month after treatment, the prevalence of depression in patients was reduced to 46 persons. This decrease was statistically significant. Level of anxiety was reduced after taking the methadone. Also the quality of life after treatment with methadone was significantly more than ago. Use of alternative treatments such as methadone therapy can be effective in reduction the prevalence and severity of depression, anxiety and increase the quality of life.

Visual fatigue could decrease precision and increase human error, hence declining productivity. Development of ergonomic laboratory instruments for diagnosing, evaluating, and monitoring visual fatigue could help productivity enhance in different occupations. This study aims to develop and validate laboratory instrument of visual fatigue (VFM-90.1). Method & Materials: VFM-90.1 was designed and programmed based on registering changes in Flicker value. Then a cross sectional study was done to validate instrument, enrolling 248 users of video display terminals (VDT) and using visual fatigue questionnaire of VDT users. For measuring error of the instrument, an oscilloscope was use as the initial standard and for analyzing the data simultaneously gathered through the questionnaires and the instrument, spss11.5 was employed, subsequently, sensitivity-specificity values calculated and receiver operating characteristic (ROC) curve and areas of visual fatigue, obtained. VFM-90.1 had resolution of 0.1 Hz and the average error of 0.8%. The maximum changes in flicker value and questionnaire score (prior to and after intervention) was calculated respectively as (-4.1) Hz and 5.83 (in 0-10 scale). The correlation between instrument results and the questionnaire was (-0.87) and cutoff points at (-0.5), (-2.2), and (-3.4) were defined as non, low, and moderate visual fatigue areas, respectively. The values less than (-3.4) were assigned to indicate severe visual fatigue area. VFM-90.1 has scientifically adequate precision and authenticity and could be used as an initial standard instrument in ergonomic laboratories regarding easy application in scientific research and clear evaluation and interpretation of the data on visual fatigue obtained from this instrument. So, an effective measure could be taken to enhance ergonomic and occupational health.

Hospital waste contains biological agents and chemical compounds which are toxic and dangerous for health of patients, personnel and clients. Due to the presence of hazardous and infectious materials in the hospital waste, appropriate management should be applied to them. The aim of this study was to compare the waste management system in small and large hospitals of Tehran city in 2012. In this cross - sectional study the solid waste management in two large hospitals and three small hospitals in Tehran city in 2012, were compared. Hospital wastes was segregated and weighted initially, and then the percentage of infectious and non-infectious waste was determined. According to the World Health Organization questionnaire the status of hospital waste management and waste treatment facilities in these hospitals were evaluated. Average waste generated in large hospitals in 4.5 and small hospitals in 4.87 kg per day was in bed. Health level of storage systems and waste collection of hospital wastes were in 91.5% and 100% in large hospitals and 73% in small hospital, respectively. Biological indexes showed that waste disposed at large hospital 1 and small hospital 4 were not in a safe mode. Discussion & There is no significant difference between the amount of waste generation in small and large hospitals, but the amount of infectious wastes in small hospitals was in 1.75 times greater. Health level of waste collection and storage system was significantly higher in large hospitals. Hospital waste management in large hospitals was much better than in small hospitals.

Antioxidants are molecules that inhibit the action of free radicals and vitamin E is one of the most important antioxidant compounds. Vitamin E is insoluble in water and it will limit its application in polar media. Many studies are performing for finding of water-soluble analogues of this compound at present. In this study, polar and synthetic analogue of vitamin E (IRFI005) was used for survey the expected properties of vitamin E in polar media. Evaluation of IRFI005 extra-cellular antioxidant activity was studied by spectrophotometric method at 430 nm and by using the Galvinoxyl free radical in 1:2 and 1:4 (IRFI005: Galvinoxyl) molar concentrations. Intra-cellular antioxidant effects of 5 µM IRFI005 was also studied by using DCFH2-DA colored probe and cumene hydro peroxide in DCF method. IRIF005 inhibits the oxidant molecules in the inside and outside media of the cell. Galvinoxyl has lower optical density (OD) in ratio 1:2 and it has been removed completely from the media. Each IRFI005 molecule is able to remove two free radical molecules. It also suppresses CHP effect into the cell and inhibits the increase of fluorescence intensity. The findings suggest that in polar media, IRFI005 is a powerful, dose-dependent and active antioxidant and it can inhibit oxidant molecules of inside and outside the cell.