مجله دانشگاه علوم پزشکی اردبیل
پیاپی 7 (بهار 1382)

Breast cancer is the most common type of cancer among women worldwide and accounts for the majority of their deaths due to the cancer. Hence, diagnosing its risk factors is of great importance. In this study the association between abortion and breast cancer risk was investigated. In this Case- Control study in Mashhad, 105 patients with confirmed breast cancer were compared with 105 healthy women who were living in their neighborhood and were the same age. A questionnaire including demographic information as well as same questions regarding the factors associated with conception and emphasising abortion were used to collect the data, which then were analyzed using SPSS ver 9. the findings indicated a relationship between breast cancer and history of abortion, compared to women with no history of abortion (OR=2.09 95% CI=1.18- 3.69). Also there was a significant relationship between the frequency of abortion and breast cancer (P=0.008). but odds ratio was not higher among women whose age at first abortion was less than 20 years. Also abortion before first full- term pregnancy increased breast cancer risk (OR= 5.97 95% CI=1.18-19.6). But the age at the time of abortion did not have any effect on the breast cancer risk. The findings suggested that the risk of breast cancer has a positive relationship with frequency of abortion and the risk is even higher if the abortion occurs before the first full-term pregnancy. Thus, health interventions seem to be necessary in this regard.

Swallowing foreign bodies and their impaction in esophagus is common among children and proper diagnosis and treatment of this problem will decrease its complications. The objective of this study was to evaluate esophageal foreign bodies. 62 patients with complaining about foreign body ingestion were studied and factors such as age, sex, the kind of foreign body, the treatment done, its complications and the length of hospitalization were considered. Of sixty- two patients, 30 were male and 32 were female. Coin was the most common foreign body in children (24 cases) while in adults bone (chicken or fish) was more common (19 cases). In the patients most of the foreign bodies were impacted in the upper esophagus at the cricopharengeal junction. In all patients except one case (in which endoscopic forceps was used to remove the foreign body) esophagoscopy was performed under general anesthesia to remove the impacted foreign bodies. Complication was seen in one case as bleeding. Since the esophageal foreign body is prevalent among children it is necessary to prevent it through offering adequate to parents.

Poster is a non-projector, visual, graphic and printed medium that is applied in various cases specially in health education. On the other hand, one of the health education experts task is evaluation of educational methods and media. Since few studies were performed on effectiveness of posters on knowledge of people, this study was designed to determine the percentage of people who looked at the posters in health centers and also to determine the level of knowledge attained from these posters located in different places of health centers. This was a semi-experimental study. The population was people who referred to Shahid Gannadi health center. Samples were selected by simple random method. The data were collected by a questionnaire. The posters were fixed in three places during three different stages and the collected data were analyzed. The findings showed that from among these subjects, 18.8% in the first stage, 20.8% in the second stage and 61.2% in third stage observed the fixed posters. The probability of the poster to be seen near the doorway and examination room was equal (Odds Ratio=0.9) whereas the probability of the same posters to be seen in waiting hall was 7 times as much as the previously mentioned locations. The ANOVA indicated no significant difference between demographic variables (age, sex, marital status, ets) of study subjects and their knowledge scores. The study showed that People paid very little attention to fixed poster. Therefore, regarding the role of posters in increasing the knowledge level, several strategies should be employed to make people pay more attention to these posters. Following the accepted standards in preparation and fixation of posters and preparation of three dimensional boards for the posters in health care centers are suggested.

Stroke is a leading cause of death and disability worldwide. It is more common in men than in women, however more than half total stroke death occur in women. Several conditions and lifestyle factors have been well established as risk factors for stroke. The purpose of this study was to asses the magnitude of classic stroke risk factors and its pattern in women. A total of 62 patients with first-onset ischemic stroke were accrued from neurology unit of Alavi hospital during 2002 and compared with their age-matched controls from other units of same hospital. Information concerning potential risk factor exposure status was collected by structured questionnaire at interviews. Stroke risks were estimated by calculating the odds ratios. Significantly increased risk of stroke was found among women with hypertension (OR=8.4 CI=3.7-1.8), current smoking (OR=4.2 CI=1.1-16), diabetes (OR=3.7 CI=1.4-9.7) and heart disease (OR=3.2 CI=1.2-8.4). Association of other factors (passive smoking, Hypercholestrolemia) with stroke was not significant. Hypertension, diabetes, current smoking and heart disease are major risk factors for stroke in women. Given that the majority of these factors are either correctable or modifiable, prevention strategies should be planned in accordance with this point in order to reduce the occurrence of stroke in women.

Self Confidence, is a continuous evaluation of an individual on himself. Hence it is important regarding the mental health and the personality balance. Due to the problems that low self-confidence brings about especially during the youth age and regarding the prevalence of this problem among adolescents, the present research was conducted in order to investigate the level of self-confidence among students. Self-confidence of 500 students was determined using Eysenck test. Multistage sampling was employed to select 7 out of 15 boys high schools randomly In each grade of study the required numbers were chosen randomly proportionate to the number of students in that grade. Scores more than 21 showed high self-confidence, 14-21 average and less than 14 indicated low confidence. To analyze the data, Chi- square and Mantel- Hanzel tests were used, with 95% significance. 29.6% of students have had high self-confidence, 57.8% of them had average self-confidence while 12.6% of them had lower level of self-confidence. No significant relationship was seem among the rank of birth and the literacy of parents with the level of self-confidence. However there was a significant relationship between the number of siblings (P=0.0135) and study grade (P=0.0018) with the level of self-confidence. As a result, 11.5% of the students in the first grade, 6.6% in the second grade and 20.5% in the third grade had low self-confidence. The prevalence of low self-confidence among third grade high school students, warns that they should be paid much attention by their parents and their school officials.

The fast population growth is one of the basic problems in Iran and using family planning devices has a remarkable role in decreasing it. The findings of researches carried out nationwide indicate the effectiveness of instruction in the application of family planning methods and devices. The objective of this study is determining the level of knowledge of 15-49 year-old women under Ardabil health and treatment center services. 138 qualified mothers were chosen randomly from among 15-49 year-old women under Ardabil health and treatment centers services. These subjects were selected from among 14 centers (10 mother from each center) and had secondary school level of education. This descriptive cross-sectional and prospective research was conducted by filling out the pre-planned questionnaire and preparing educational booklets and giving them to the mothers under the study as pretest and post-test procedures during the time span of December 2000 to May 2001. No meaningful relationship was found between employment and utilizing family-planning devices. The results of Mc-Nemar test and t-test showed that statistically the instruction given with regard to the method of beginning to take anti-gestation pills, method of the intervals of taking the anti-gestation pills, taking measures at the time of forgetting to take anti-gestation pills, the preference of vasectomy to tobectomy, the interval between the injection of anti-gestation ampoules and the duration of IUD effectiveness before and after studying the manuals demonstrated a significant difference. Education plays an important role in increasing the knowledge level of the population under study and hence it improves their performance about family planning. So this instruction is recommended to be followed seriously.

Nutritionists have traditionally recognized breakfast as the most important meal of the day. The importance of eating breakfast is for growing and nutritional well being of children. While health habits such as eating breakfast, maintaining weight, and sleeping regularly are related to the longevity of adults, very little is known about the health habits of disadvantaged school-age children. This study set out to evaluate eating breakfast among adolescent girls and its relationship with body mass index, weight and nutrient intake. This descriptive cross-sectional study was done on 611 adolescent primary and secondary school girls (10-14 years old) in Ardabil. Anthropometric studies (height, weight, and MAC) and nutritional status (24 hour recall and food frequency) were done, and the students were asked about eating breakfast and other snacks. The collected data were analyzed using SPSS ver. 9 and Food Processor. About 16.85% of girls had come to school without eating breakfast. BMI and body weight of these students were significantly more than those of girls who ate breakfast (P<0.05). On the other hand snack intake among the girls who did not use to eat breakfast was more than that among breakfast eaters (P<0.05). The amount of calorie, protein, thiamin, niacin, calcium and iron intake in breakfast-eating girls was more than those among non-eaters (P<0.05). The amount of folacin, riboflavin, calcium and zinc intake in non-eaters was less than recommended dietary allowance of WHO. The result of food frequency showed that the consumption of food such as protein different types of bread, potato, and legume among breakfast eaters was more than their consumption among non-eaters. This study indicated that eating breakfast can provide adequate calorie and nutrients but its omission can not only lead to lower calorie and nutrients intake but also have an unfavorable effect on food habit and weight of the students.

Tuberculosis is a diseases which is severely threatening the individuals health and is spreading quickly. Moreover, the appearance of new strains resistant to drugs has complicated the issue. Since there is no information available regarding the present drug-resistance situation of patients suffering from tuberculosis in Mashhad, this study was conducted to determine the prevalence of this resistance in this city. To determine prevalence of anti-tuberculosis drug resistance in Mashhad, drug sensitivity of 75 M. tuberculosis strains isolated from patients with pulmonary and extra-pulmonary tuberculosis from 20 Feb. 2002 to 20 Aug. 2002 was studied using the indirect proportion method. Every strain was tested against Rifampicin (RMP), Isoniazid (INH), Ethambutol (ETM), and Streptomycin (STM). Medical records of the patients were reviewed. Patients with no or less than 1 month treatment were defined as new cases and those previously treated for more than 1 month were defined as previously treated cases. Of 75 isolates, 70(93.33%) were from new and 5(6.66%) from previously treated cases. 68 patients (90.66%) were suffering from pulmonary and 7(9.33%) from extra-pulmonary tuberculosis. Of 75 isolates, 23(36%) were resistant to at least one anti-tuberculosis drug. The highest rate of resistance was observed to streptomycin. Three of the 75 strains (4%) were resistant to all four drugs. 1.43% and 40% of strains isolated from newly and previously treated patients respectively were multidrug resistant. In this study new cases with MDR-TB were less prevalent compared to other studies. Most drug resistance and MDR-TB were associated with previous treatment. Continual evaluation of drug resistance following DOTS implementation seems to be necessary.