فصلنامه دانشگاه علوم پزشکی و خدمات بهداشتی درمانی زابل
سال ششم شماره 3 (پاییز 1393)

Sufficient nutritional intake before and during pregnancy has significant impacts on the promotion of maternal and neonatal health. Some factors such as anthropometric indicators and biochemical measurements reflect a pregnant woman’s nutritional status and energy store. The aim of the current study was to determine the nutritional intake، anthropometric measurements، and hemoglobin level of expecting women in the third trimester of pregnancy and to assess their correlations with the birth weight of neonates. The current study was performed in Ali-Ibn-Abi Talib and Tamin-Ejtemaei hospitals in Zahedan after gaining the approval of hospital authorities. Finally، 500 pregnant women were selected for this study. Anthropometric (e. g.، height، weight، fundal height، and abdominal circumference) and biochemical measurements (hemoglobin level) were performed by standard procedures. Family history and nutritional intake of the subjects were recorded، using a questionnaire and 24-hr recall method. Data were analyzed by SPSS software. As the findings indicated، the mean daily energy and protein intakes of the subjects were 1802±437. 0 kcal and 70. 7±18. 9، respectively. In addition، calcium، iron، zinc، and magnesium intakes were 544±289. 0 mg، 16. 1±4. 3 mg، 10. 6±3. 5 mg، and 266±79. 0 mg، respectively. The mean height، weight، body mass index (BMI)، fundal height، abdominal circumference، and hemoglobin level were 156. 4±5. 5 cm، 62. 6±6. 8 kg، 25. 6±3. 6 kg/m2، 43. 2 cm، 104. 1±3. 6 cm، and 11. 1±1. 1 g/dL، respectively. The percentage of nutrient intake adequacy، with reference to Recommended Dietary Allowance (RDA)، showed that protein and magnesium intakes were sufficient (more than 75% of RDA)، while daily energy، calcium، zinc، and iron intakes were inadequate in the subjects. The mean weight of neonates was 3 kg، and the weight of 13% of the infants was < 2. 5 kg. The mean birth weight of neonates significantly elevated with increasing age، educational level، and family income. The increase in anthropometric indicators، hemoglobin level، energy، and nutritional intake of pregnant women resulted in an increment in the mean birth weight of neonates. Our finding showed that energy، protein، and calcium intakes in the third trimester of pregnancy were significantly correlated with the birth weight of neonates (P<0. 05). In addition، data analysis showed that maternal height، weight، fundal height، abdominal circumference، and hemoglobin level were significantly correlated with the birth weight of neonates (P<0. 05).

Today, the increasing prevalence of musculoskeletal disorders has become a major health concern in all societies. Unpleasant working conditions are among the main causes of musculoskeletal disorders. Therefore, this study was performed with the purpose to evaluate the relationship between ergonomics and musculoskeletal disorders, induced by working conditions, among librarians in Zabol city, Iran, in 2013. This descriptive-analytical study was performed on 51 librarians in Zabol city in 2013. Data were collected by Standardized Nordic Questionnaire and a checklist of library ergonomics. Data analysis was performed by SPSS version 18, and descriptive and inferential statistical methods were applied. The obtained results showed that library ergonomics are not satisfactory in Zabol city; also, neck pain accounted for the majority of musculoskeletal disorders (56.9%). Moreover, there were significant relationships between the upper back pain and body posture (P=0.003), lower back pain and body posture (P=0.008), neck pain and body posture (P=0.002), and thigh pain and the type of work (p=0.045). The results showed that ergonomics have significant impacts on musculoskeletal disorders (back, thigh, and neck pain) and one’s physical health.

Mindfulness is a mind-body technique, which is used for reducing stress and promoting quality of life in many patients with chronic diseases. The purpose of this study was to evaluate the effectiveness of mindfulness-based stress reduction (MBSR) on the pain intensity of patients with migraine. Only 60 students in a total of 124 candidates met the inclusion criteria. The subjects were randomly allocated to intervention and control groups. The intervention group participated in 8 weekly MBSR sessions at the counseling center of Zabol University during October and November 2011. McGill Pain Questionnaire was used for assessing pain intensity before and after the intervention. Finally, multivariate analysis of variance (MANOVA) was used for comparison between the groups and subscales. The obtained results showed no significant difference between pre- and post-test results in the control group. However, a significant difference was observed between the pre- and post-test results in the intervention group (P≤0.01). There was also a significant difference in post-test pain intensity between the control and intervention groups (P≤0.01). The results of the current study indicated the effectiveness of MBSR on decreasing perceived pain intensity in patients with migraine.

Chronic renal failure and hemodialysis can lead to numerous self-care deficits in patients. Promotion of psychological self-care behaviors can help patients maintain their mental health and well-being. The present study was performed to determine the impact of a self-care program, based on Orem’s Self Care Model, on psychological self-care deficits in hemodialysis patients.

In this quasi-experimental study, carried out in 2013, thirty-six hemodialysis patients were selected via convenience sampling from the hemodialysis ward of Vali-e-Asr Hospital in Birjand, Iran. Data were collected, using a self-care deficit questionnaire, which was designed based on Orem’s Self-Care Model. After confirming its validity and reliability, the questionnaire was completed during interviews. By considering the subjects’ self-care deficits, the program was carried out via face-to-face interviews. One month after the intervention, the questionnaire was filled out again. Descriptive and inferential statistics were calculated by SPSS version 17. P-value ≤ 0.05 was considered statistically significant.

As the findings showed, psychological self-care deficits included knowledge deficit related to effective relaxation techniques and anger management via problem-solving, inability to use relaxation techniques and anger management via problem-solving, deficit in using positive sentences, deficit in expressing emotions toward family and friends, social isolation, grief, and despair. Before the intervention, the majority of patients (n=33, 91.7%) had knowledge deficit related to effective relaxation techniques, deficits in anger management via problem-solving, and inabilities to use relaxation techniques. However, after the intervention, the number of patients with knowledge deficit reduced to 13 (36.1%) (P< 0.001), and the number of subjects with deficits in using relaxation techniques decreased to 18 individuals (50%) (P=0.001), according to McNemar’s test.

The present study showed that a self-care program, based on Orem’s Self-Care Model, can significantly reduce psychological self-care deficits in hemodialysis patients. Therefore, nurses can apply self-care programs based on Orem’s Self-Care Model to improve patients’ mental health.

Hospital waste constitutes a large part of municipal waste and is considered a potential health hazard. In fact, infectious wastes can have adverse impacts on the health of individuals. This study aimed to determine the effect of management programs on the generation of infectious wastes at Imam Khomeini Hospital of Sardasht. In this cross-sectional study, effective methods for reducing infected wastes produced at Imam Khomeini Hospital of Sardasht were evaluated during the first half of 2012. Data were collected using daily report forms of hospital waste separation during the study period and were classified according to each hospital department. For data analysis, paired sample t-test was performed, using SPSS. Application of waste management strategies, despite increasing the number of patients, led to a decrease in infected waste generation per capita per day from 3.66 in the first six months of 2011 to 2.69 in the first months of 2012. The infected waste generated per capita in the first six months of 2011 and 2012 were 94.71 and 78.19 kg per day, respectively. Overall, the produced infected waste after the application of management programs reduced by 17.44% in 2012. According to the obtained results, management programs including source reduction and separation methods can be effective and applicable in controlling and reducing the production of infected wastes. Implementation of these programs requires continuous monitoring, assesssment and identification of effective factors for infected waste production by health experts, and the collaboration of other sectors and staff.

Venous thromboembolism (VTE) and the resulting complications are common causes of long-term morbidity and hospital-related mortality. The pathogenesis of deep vein thrombosis (DVT) involves a combination of hereditary and acquired factors. In the present study, the acquired risk factors, antithrombin III, homocysteine, and factor VIII were evaluated in patients with thromboembolic events at Hajar Hospital of Shahrekord, Iran. In this case-control study, 25 VTE patients and 25 healthy controls, without a prior history of VTE, were evaluated. DVT and pulmonary thromboembolism (PTE) were diagnosed by Doppler sonography and CT angiography of the chest, respectively. Serum homocysteine level was evaluated by ELISA kit, antithrombin III by chromogenic assay, and factor VIII level by coagulation assay. The obtained data were analyzed by SPSS version 18. The prevalence of thrombophilia in VTE patients was estimated at 32% (8 out of 25 patients). Aging was a significant acquired risk factor for VTE (12 patients, 52%). The results showed that 12% of the subjects had hyperhomocysteinemia, including 20% of the case group and 4% of the control group (P=0.82); also, 18% of the study group had low antithrombin level. None of the groups had high levels of factor VIII. Considering the higher prevalence of antithrombin deficiency in our study, in comparison with previous research in other regions, further studies with a larger sample size are required.

Pregnancy-related mortality is one of the most important indicators of the overall health of a population and the functioning of the healthcare system. Mainly, pregnant women are admitted to intensive care units (ICUs) for reducing maternal and neonatal complications and mortality. The present study aimed to determine the causes and outcomes of maternal hospitalization during pregnancy and puerperium in the ICUs of Babol and Sari teaching hospitals during April 2001-March 2012. In this descriptive analytical study, all pregnant women, admitted to the ICUs of Babol and Sari hospitals during 2001-2012, were enrolled. Demographic data, as well as complications and procedures, documented in hospital records, were collected. For data analysis, Chi-square test was performed, using SPSS version 18. In 64 pregnant women, who were admitted to the ICUs, hypertension was the most common cause of hospitalization (39.1%). The most commonly performed procedure was blood transfusion (32.8%), followed by intubation (21.9%). Overall, maternal death was reported in 6 cases (9.4%), and embolism was observed in 4 patients (6.3%). Cesarean section (c-section) was performed in 93.75% of subjects, hospitalized after childbirth. In this study, the most common cause of ICU admission was hypertension, and the most commonly performed procedure was blood transfusion. Since c-section was the most common mode of delivery, unnecessary cases of c-section should be avoided. In addition, identifying factors, which lead to ICU admission or death in pregnant women, and increasing the quality of prenatal care for reducing maternal and mortality rates are essential.

Complications associated with atherosclerosis are the most common cause of human mortality. Hyperlipidemia is an important risk factor for atherosclerosis. In fact, a decline in cholesterol concentration decreases the incidence of coronary artery diseases by approximately 50%. Considering the use of herbal medicine as one of the earliest modes of treatment, this study aimed to determine the effect of ginger on reducing lipid level in humans. In this study, 90 patients with hyperlipidemia were randomly allocated to 3 groups of 30 subjects. The first group only received anti-hyperlipidemic medications, the second group was given anti-hyperlipidemic and placebo medications, and the third group received ginger in addition to anti-hyperlipidemic medications for 7 weeks. Fasting blood sugar (FBS), blood pressure, and serum lipid were evaluated before and after the intervention. FBS, triglyceride, cholesterol, high-density lipoprotein (HDL), and low-density lipoprotein (LDL) levels were not significantly different among the three groups before the intervention. However, after the intervention, FBS was different between the first and third groups. Moreover, triglyceride level in the third group was significantly different from those reported in the first and second groups. Also, HDL in the third group was significantly different from those of the first and second groups. Given the significant effects of ginger on blood sugar and serum lipid profile, we recommend ginger for controlling hyperlipidemia, hyperglycemia, and hypertension.

Polycyctic Ovary Syndrome (PCOS) is a common endocrine disorder in women, which can lead to cardiovascular and metabolic complications. The measurement of carotid intima-media thickness (CIMT) by sonography is an indicator of atherosclerosis, which is highly associated with cardiovascular diseases. The main objective of this study was to compare CIMT between PCOS patients and healthy individuals. This case-control study was performed on 30 patients with PCOS (case group) and 26 healthy women (control group), referring to the obstetric department of Mousavi Hospital in Zanjan, Iran. Lipid profile, fasting blood sugar (FBS), insulin level, blood pressure, waist circumference, and CIMT were measured in the studied subjects. T-test was performed for comparing the means of studied samples. P-value < 0.05 was considered statistically significant. The mean±SD of age was 29.52±4.01 years in the case group and 33.94±6.43 years in the control group (P=0.002). The mean±SD of CIMT was 0.32±0.06 in the case group and 0.29±0.05 in the control group. The prevalence of metabolic syndrome in the case group was higher than that reported in the control group (33.33% vs. 19.23%). In fact, PCOS and metabolic syndrome had cumulative and interactive effects on CIMT; however, the difference between the two groups was insignificant (P=0.263). The mean values of triglyceride, high-density lipoprotein (HDL), FBS, blood pressure, waist circumference, and insulin level were higher in the case group, compared to the control group; however, the difference between the two groups was significant only in terms of waist circumference (P=0.001). The results of the present study demonstrated that CIMT in patients with PCOS was higher than that reported in healthy women. In addition, this increment was found to be more significant in patients with PCOS and metabolic syndromes. Therefore, complete lipid profile tests and CIMT measurement are highly recommended for these patients at lower ages to prevent cardiovascular events.