مجله دانشگاه علوم پزشکی مازندران
پیاپی 111 (فروردین 1393)

Background and Colorectal cancer (CRC) is one of the most prevalent health problems in the world and Iran. This study aimed at determining the survival rate of patients with CRC and the factors influencing it in Iranian patients. A prospective cohort study was carried out in patients attending 10 state and private hospitals in Tehran during 2006-2011. In this study 1127 patients (totally 2570 individuals-year) were followed up every six months and the follow-up duration was from the definite time of CRC diagnosis until death (or censoring). Only 2% of the patients were censored. Data was analyzed using stata software, bivariate and multivariate analyses, and also Cox regression. The mean age of the patients was 53.5 ± 14 years old at the time of diagnosis. Most of the patients were older than 45 years of age (69.7%). The age at diagnosis was significantly different between men and women (P<0.03). The patients were 61.2% male and the rest were female. The rates of mortality in male and female were 96.9 and 83 in 100,000. After the diagnosis has been made 75%, 50%, and 25% had a survival rate of less than 2.72 years, 5.84 years, and longer than 13 years, respectively. In Cox model some variables including ethnicity, marital status, cancer grade, family history of caner, and smoking were the main determinants of survival. The mean survival time was 5.8 years after diagnosis has been made which shows more improvements compared to previous studies. This study provides some information on CRC survival rate so that action plans could be designed to prevent and control this disease.

Background and Febrile seizure is a seizureassociated with fever without any evidence of intracranial infection or electrolytic disorder.The age of affected child is more than one month and without any previous seizure or fever. The peak incidence is at 18 months. Treatment is consisting of managing the seizure by anticonvulsant medicines that are administered for preventing of recurrence. In this research, diazepam and clobazam were evaluated for prevention of febrile seizure recurrence in patients admitted in Taleghani hospital. 150 patients with simple febrile seizure in age range of 6 months to 6 years of old were in two medicinal groups randomly involving diazepam and clobazam after control of seizure. Each group include of 75 patients. Diazepam was taken with dosage of 0.33 mg/kg/8h and about clobazam; the dosage was 2.5, 5, 7.5 and 10 mg basis on body weight. The results involving fever episodes in each 3 months, side effects of medicines and recurrence were recorded in a check list and finally were analyzed. 32 patients were removed of study because of having the exclusion criteria and finally 118 patients, 61 cases in diazepam group and 57 cases in clobazam group, were studied. There were 62 males and 56 females in this population. The mean age was 21.05±10.10 months and 21.96±10.74 months in diazepam and clobazam groups, respectively and was 21.49±10.39 in total of population.Recurrence was evaluated relation to medicinal effect, age, sex and family history and personal history of febrile seizure and distance between fever and seizure. Also medicinal side effects involving ataxia, drowsiness and other side effects (vommiting, anorexia and irritability) and their relation to age and sex were evaluated. According to statistic tests, there was not any significant differences between two groups in considered parameters (P>0.05), but there were some differences in some cases clinically. Just drowsiness showed a significant difference between two groups (P= 0.000). Generally, Treatment by clobazam has been caused recurrent and complications less than diazepam, although it has required a larger sample size for confirming these results.

Background and post stroke depressionis one of the common emotional disorders affecting stroke survivors.Strokeis one of neurologic diseases and is a public health problem. the purpose of this study was to deter mine the relationship of risk factorswithprevalenceofpost stroke depression. this descriptive study was performed with relevant sampling metod on 116 inpatient ischemic strokethat admitted in the department of neurology BoaliSinahospital in Sari. recognitionbrainischemicstroke was on the basis clinical recognize neurologist and confirmed with use Brain. C.T.S & M.R.I. Frequency of depression, according to DSM IV criteria & HADS inquiry determined and demographic data were registered by the patient andrisk factors were registered on the basis resultparaclinic testes then confirmed by the physician. all of data analyzed by SPSS 16, Chi Square, Lojestic Regression. findingshowed in this study % 47/4 of patient sufferedpost stroke depression. the frequency of depression in was significantly higher in women (29.3%) than men was (18.1%). there was no significant relation between depression and age andliteracy level. there was significantrelation between depression with sex (sig= 0.004) & diabet mellitus (sig= 0.000) & hypertension (sig= 0.003). our result study show that post stroke depression is prevalent in our society, andthisismoreprominent among women. there is significant relation between depression with sex & diabet & hypertension. earlydiagnosisand treatment and psychologist or psychiatry intervention can help to decrease post stroke depression. specially in women and improve quality of life & expectancy of lifein these patients.

Background and Mercury is a toxic heavy metal which causes irrevocable intense nerve-recognition disturbance to human. Excess contact to mercury causes diseases like tremor, losing sensation, decreasing vision and hearing or growth. WHO recommended the most amount of mercury absorption about 0.3 mg per week and the most concentration in water about 1µg/L. The purpose of this study was to investigate the efficiency of Lcysteinefunctionalized single-walled carbon nanotubes (SWCNs) in mercury removal from aqueous solutions. In this study, single-walled carbon nanotubes was used as absorbent. The effects of some parameters such as pH, absorbent dose, contact time and mercury concentration were assessed. All experiments have been done according to standard methods. The sample size was determined by Box-Benkan method. The result showed that absorption rate increased by increasing of pH, contact time and mass CNTs dose. The Hg removal efficiency decreased by increasing of initial Hg concentration.The maximum and the minimum of absorption rate are 95 and 22 percent, respectively. ANOVA showed that RSM has a significant relationship for single-walled carbon nanotubes with linear conditions. The study demonstrated that SWCNT-Cysteine is a well absorbent for Hg removal from aqueous solutions Therefore, it can be effective for the removal of mercury from aqueous solutions.

Background and The need for privacy is a basic human right. Nurses are expected to respect the patients’ privacy. This study investigated the viewpoints of patients and nurses regarding keeping the patients’ privacy during nursing care. In this cross sectional study 127 nurses and 384 patients meeting the criteria for study were selected through randomized sampling. Data was collected by a questionnaire designed by Heydari (2000) and analyzed using t-test and ANOVA in SPSS ver.18. The results showed a significant difference on average score of the realm of human between nurses and patients (P<0.05). According to the studied population the levels of paying respect to human realm and private space in hospital were moderate. Significant relationships were seen in viewpoints of nurses’ considering their gender and educational level. We also found a significant correlation between the patients’ viewpoints and their level of education and place of residence. To enhance the quality of services provided by nurses they should consider patients’ right to privacy and care for them while respecting their privacy.

Background and Cardiopulmonary resuscitation is used for saving patients’ life and its success may increase by recognizing the aspects and factors influencing it. However, some factors are believed to be neglected. This study investigated the success of resuscitation in CPR team’s shift change. During the study a total of 307 patients was under CPR and the outcome was successful in 78 cases and 20.5% of the patients discharged from hospital alive. The most popular diseases that resulted in CPR were internal diseases and cancers and the best result was obtained in poisoned cases. The rate of CPR was higher at night shifts, but there was no significant correlation between the time of shift change and the interval between these times and the outcome of CPR. Our results are consistent with those of other studies in rate of success in CPR and suggest no relationship between this rate and the time of CPR team’s shift change. This study shown that CPR successfulness in emergency part of Imam Khomeini hospital is similar to other part of world and although changing time of CPR group's shifting is more critical, there are no statistical relationship with result of CPR.

Background and One of the most important of post coronary artery Angioplastycomplications is hemorrhage and hematoma. In our country initial hemostasis is done by hand pressure in puncture site and use of sand bag and absolute immobility for maintain hemostasis. Sand bag pressure and applied immobility lead to significant patient discomfort. In this regard and in order to achieve a solution for reducing complications after angioplasty the aim of this study is determine the effect of two methods of sand bags and air cushions on reducing complications after coronary artery angioplasty. This quasi-experimental study was performed on 80 patients for elective angioplasty, based on inclusion and exclusion criteria were selected and randomly assigned to two groups of sandbag and the air cushion. Complications after angioplasty including low back pain, fatigue, and inguinal discomfort in both groups were evaluated during a 6 hours rest. Regarding the severity of back pain, fatigue as well as discomfort in the groin immediately following the removal of the sheath; no significant difference was reported in both groups. A significant difference was observed in sandbag group in later stages (P<0.001). It also revealed that this group had to receive more narcotics to relieve the pain (P=0.0025). There was no significant difference in the incidence of hematoma between the two groups (P=0.314). Regarding the findings of the study, it was revealed that applying air cushion to the femoral artery puncture site will lead to the possible position change in bed, no increase in hematoma and bleeding, significant reduction of back pain, patient comfort and also reduction in the prescription of analgesics.

Background and Urinary tract infection (UTI) is one of the common infections and the second cause of infection in human body and in under developing countries it's rate is at least 250 million people annually. the main cause of these infections in most records are gram negative bacterias as E coli which are seen in both age groups and both sexes but it's incidences in female are more.The base of treatment for urinary infection is finding of an appropriate antibiotic with high effectiveness.Today, the problem of antibiotic resistance is an important challenge in treating of these infections especially those for gram negative bacterias. According to high intaking and unnecessary usage of antibotic especially in urinary infections and presence of high resistances, this study has been programmed to assay the schedule of Ecoli-antibiotic resistance in collected urines of urinary infected patients. In this study urine samples have been collected by Midstream clean catch method then cultured in two blood agar and EMB medium with standard loop and incubated for 24hr in 370 In period of 12 months, from 1147 studied samples, 208 positive samples have been reported in which the rate of positive cultures in women was more than men and the mean age range in women was less. The most antibiotic resistance for Escherichia coli was for nalidixic acid, cotrimoxazole and cefazolin and the most sensitivity was for imipenem, nitrofurantoin and piperacillin. According to recent study, we can conclude that urinary infection of Ecoli in women is more than men and happening in less ages; may be because of physiological condition of females; and also we can suggest imipenem, nitrofurantoin and piperacillin as the most effective with lower resistances antibiotic which can be considered in medical prescriptions

Background and One of the most important subjects of the science of demography that is demanded by socio-economics planners, is the life table. The outline of this table- life expectancy- shows the change process of this index during time and consequently the health system performance. In fact, the study is a epidemiologic explanation and we collected its relating data from the Health Center of Sarry and the recorded population during 2005-2010 in the city. Then we calculated the life expectancy index by using the table of current life- for men and women- based on the mortality, survival likelihood, and the number of population during this period. Our conclusions show that the maximum life expectancy form men refer to 2007- 76.52 years- and for women refers to 2005- 79.68 years-. Apparently there is a significant difference between men and women about the life expectancy. Based on our results, the changes of life expectancy during latter 6 years show an ascending figure. The consideration of healthy indexes at the beginning of life, psychology healthy in women and disaster reduction are some important factors for increasing the life expectancy in the society.