محسن شجاع

Despite impressive advances in pediatrics, preterm labor is known as the most common cause of infant mortality in world and identifying its related risk factors could bring about to reduce of preterm birth. Therefore the present study was aimed to determine the prevalence and contributing factors to preterm birth in alive newborns in Bojnurd.
Material & This study was a cross sectional study conducted on 3561 alive newborns in Bentolhoda hospital Bojnurd in 2012. Questionnaire was completed from the records of newborns and mothers and data were analyzed with SPSS18 software and presented with t-tests and chi-square.
The incidence of preterm birth was 7.2 %. The mean of mothers’ age was26.8 ± 6.4 years, 55 percent had a high school education and 54% of the newborns in the study were male. Multifetal (p=0.001), Early rupture of membrane (p=0.002), preeclampsia (p=0.03), breech presentation (p = 0.004), use of modern methods for gestation (p = 0.01) pregnancy infection (p = 0.01) contribute to premature birth. There was not relationship between newborns sex, maternal age, Placental abruption, abortion, addiction, trauma in pregnancy and preterm delivery.
Considering that preterm birth is a multifactorial phenomenon, identification of risk factors and consequently the screening and identification of mothers with risk factors for preterm delivery can play a part in drawing mothers ‘attention to consider contributing factor and safe delivery.

asphyxia increases Infant mortality rate and it can cause serious complications and long-term disability condition. Therefore this study was to assess the prevalence and associated factors of birth asphyxia.

In this case-control study, newborns of Bint al-Huda hospital in Bojnurd in 2012 were studied in terms of Asphyxia by census. With equal number of newborns with asphyxia (75 cases), control cases (75 controls) that had not Asphyxia were selected with Systematic sampling. The information was collected from the records and interviews with mothers by questionnaire. Data were analyzed by SPSS18 statistical software with independent t-tests and chi-square.

The incidence of asphyxia in this study were determined 2.1% (75 cases) and relationship between maternal height (p =0.01), the use of suction (p =0.04), the proportion of embryos with maternal pelvis (p =0.02), delayed delivery (p =0.01), cord compression (p =0.03), postpartum hemorrhage (p =0.01) and the delivery of foot (p =0.03) with asphyxia were statistically significant. The relationship between maternal age, birth weight, mother’s parity old, gender, delivery type, preterm delivery, heart disease and maternal diabetes with asphyxia was not observed.

Considering the high prevalence of asphyxia in this study, and its serious complications, control and management of affecting factors on asphyxia should be among the priorities of the health care system.

Social capital is an important issue in various stages of human life and has an important role in individuals’ social, economic, and health status. The natural process of biological and social changes causes disorders in personal affairs, quality of life, and social roles of the elders. Therefore, the present study aimed to determine the variables associated with social capital and its relationship with quality of life in the elders of Ilam, Iran.
In this cross-sectional study, 330 elders aging 60 years old and above from Ilam were selected through multi stage sampling. The demographic, social capital and life quality data were collected using standardized social capital and SF12 questionnaires.
The results revealed a relationship between individual trust and education level, occupation status, mental dimension of quality of life, physical dimension of quality of life, home ownership, and length of residence in the region. The results also showed an association between solidarity and social support and marital status, home ownership, mental dimension of quality of life, insurance coverage, length of residence in the region, and family size. Also, social trust and associative relations were significantly related to age, gender, occupation, marital status, family size, physical and mental dimensions of quality of life, length of residence in the region, and family size.
Since various factors are related to the elders’ social capital and considering the cumulative effect of the aforementioned components on social capital components, improving the modifiable factors, such as socioeconomic status, social support, and quality of life, can have a direct effect on social capital.

Work-related musculoskeletal disorders are occupational injuries that have high prevalence and are major causes of disability in industrialized and developing countries. The aim of this study was evaluate exposure of musculoskeletal disorders risk factors by quick exposure check (QEC) technique and determine the prevalence of musculoskeletal disorders in a textile industry. Methods and Materials: 44 male workers in Stretch department of Tehran textile industry that were selected through census method were participated in this cross-sectional study. Data were collected using Nordic Musculoskeletal Disorders Questionnaire (NMQ) and QEC (Quick Exposure Check) form. Statistical analyses were performed using SPSS, version 18. Results showed that the highest prevalence of MSDs in12-month past was in low back (47.9%) and then respectively in hand and wrist (27.8%), shoulder (22.9%) and neck (14.5%). The relationship between age and the prevalence of MSDs in neck and shoulder was significant (p<0.05). The relationship between BMI and MSDs in hand and wrist (p= 0.002) and low back (p= 0.04) was also significant. 80% of workers in this study in the low back, 89% in shoulder, 71% in the hand and wrist and 87.5% in the neck were at high risk of musculoskeletal disorders. based on the findings, risk level and prevalence of WMSDs in workers in this study were high. The evaluation results obtained from QEC according to the scores obtained for the whole body indicated that corrective actions in high levels of actions - done promptly -for some jobs in this industry was necessary.

Due to the elder’s growing population, as a result of birth control policy and increase in life expectancy in the world, elder’s quality of life deserves special attention. This study aim to investigate the health-related quality of life in community-dwelling older adults of Bojnourd, 2014. In this descriptive-analytical study, 200 older adults of Bojnurd city were selected through multi-stage random sampling. Date collection was carried out through “LEIPAD” quality of life questionnaire and demographic variables questionnaire. Data were analyzed by SPSS 16. The mean age of the elders was 68.91 ± 7.89 years and the sample consisted of 55% male. Results indicated that mean of quality of life score in the sample was 44.14 ± 10.46 and factors such as age, gender, marital status, occupation and schooling are of significant relationship with quality of life. Findings showed that the elders, enjoyed good level of quality of life; However, social support and participation play an important role in promotion of elder’s health and quality of life.

According to the important role of nurses, it is required to apply proper learning techniques for education of theoretical and practical skills for nursing students. Therefore this study aimed to compare the effects of tow methods including lecture and multimedia learning in learning of fundamental of nursing in nursing students. This study was conducted on 50 nursing students of nursing faculty of Esfarayen-2012. Samples were randomly divided into two groups (lecture teaching methods and teaching multimedia groups) and were trained. They were examined before and after the intervention and another test (remember) were done after 4 weeks. Data were analyzed by SPSS18 statistical software. Pre-test mean scores were significantly different with post-test and remember stage in two educational groups(p<0/001). Post-test mean scores of two groups was not significantly different, but in remember stage Multimedia training group had better mean(p<0/05). Both methods had the effect on student learning, but the effect of multimedia training method was more enduring over time. our results showed multimedia education method has more lasting effects than lecture education method. It is hoped that this method is more widely implemented with other methods to training nursing students.

the toxic epidermal necrosis syndrome is defined as severe skin and mucosal reactions which usually appears by some drugs such as phenytoin. a 35-year-old man who consumed phenytoin hospitalized due to diffuse mucocutaneous lesions and bullous lesions. After diagnosing its etiology، therapeutic actions were done similar to severe burns which led to improvement of wounds and discharging from the hospital. finding the etiology of every disease is crucial step in its treatment. When the disease is caused by drug، it is necessary to discontinue immediately consumption of this and start treatment.

Laparoscopic cholecystectomy is a way of removing the gallbladder. But like other surgeries، this procedure has some side effects such as postoperative shoulder pain. This study evaluates the effect of different gas flow rates into the abdominal cavity on postoperative shoulder pain in laparoscopic cholecystectomy patients. The study as a randomized clinical trial was conducted on laparoscopic cholecystectomy patients in Imam Khomeini Hospital- Esfarayen 2011-2012. One hundred participants were selected by available sampling، and were divided randomly into two groups of 50 patients. In group I flow rate of CO2 gas was two liters per minute and in group II flow rate of CO2 gas was five liters per minute. After reversing anesthesia، six، 12 and 24 hours post operative، shoulder pain was evaluated by Visual Analogue Scale (VAS) pain questionnaire. The study findings analyzed by independent t-test. The mean age of participants was 48. 8±7. 5 years and mean surgery duration was 36. 5±13. 1 minutes، and there was no significant differences between two groups (P>0/05). However، the mean shoulder pain scores in group I (blowing with low pressure) was differed significantly with group II (blowing with high pressure) (P<0. 05). In group I، pain was lower than group II. Results showed that if CO2 gas flow rate be two liters per minute (blowing with low pressure)، the patients complain less shoulder pain. Therefore low pressure gas insufflation for laparoscopic surgery is recommended. Further studies in this field should be considered.

Lapse is a taking drug again after a period of time after stopping the drug. And due to the high incidence of lapse in drug addicts, this study surveys the affecting factors of lapse among the patients referring voluntarily to addiction-abandoning centers. This case-control study was conducted on 200 drug addicts that referred voluntarily to addiction-abandoning centers in Esfarayen-1391 and selected by cluster random sampling. Data were collected by researcher made questionnaire by interview and documents. Data were analyzed by SPSS18 statistical software presented with t-tests and chi-square. Of 200 participants in the study, 77/5% were male, and mean of age was 45/9 years. Results showed that relationship between age (p=0/01), daily consumption (p=0/04), existing of chronic pain (p=0/02) and being with addicted friends (p=0/04) with lapse. But there was not relationship between smoking (p=0/32), type of treatment (p=0/18), marital status, education, employment and gender with lapse. According to the findings, education and intervention can change the affecting patterns of lapse and also strengthen coping skills in drug addicts for reduction of lapse.

Social capital consists of individual's communicational networks, social norms such as mutual trust and cooperation in social networks. The aim of this study was to develop a model to assess the implication of different determinants such as age, gender, occupational status, mental and physical health on social capital components to draw a correlation network for social capital determinants.

For the purpose of this study, data was used from ‘social capital' section of Urban HEART-1 survey, which included 22,500 households from all 22 districts of Tehran, who were approached in a randomized multistage cluster sampling method. Path analysis is a statistical method to test hypothetical causal models, which requires various causal (path) diagrams. To demonstrate the causal models of social capital, the hypothetical paths of various components were developed and the final model of social capital was drawn using multiple regression analyses.

Path analysis indicated that social capital components are influenced by various variables: A) Individual trust, by occupational status, marital status, and physical component of health-related quality of life; B) Cohesion and social support, by education, age, and marital status; C) Collective trust and associative relation, by family size, age and physical health. Direct effect of these variables on social capital components was more than their indirect effects (through mental health and physical health).

Social capital components are directly affected by occupational, marital, educational status, family size, physical health and duration of local residency. Planning to improve educational and occupational status, strengthening family bonds and provision of local facilities, may improve social capital.

Appendicitis is one of the most common surgical diseases that is currently treated by two surgical approaches، open and laparoscopic methods. One of the postoperative complications of appendectomy is stump appendicitis which has been reported in various forms. This report is dealing with an admitted case with lower right quadrant pain after laparoscopic appendectomy. After clinical and laboratory examination، the patient was candidate to diagnostic operation and finally the stump appendicitis was removed

Currently glucantime is used as first choice drug in treating kala- azar. Because of some rising unresponsiveness to this drug, in this study we attempt to compare glucantime with amphotericin B in treatment of kala-azar as first line of therapy. In these prospective study 19 patients aged 6.5 months to 10 years old with kalaazar were assessed. 12 out of 19 cases received amphotericn B and remainder treated with glucantime. Fever and throm bocytopenia were improved more rapidly in amphotericin B taking group. (P 0.05 and P 0.017 respectively). Two cases were died who belonged to glucantime treated group (p 0.02) all patients who received amphotericin B were successfully cured. Am photericin B can cure kalazar fully with improving fever and thrombocytopenia quicker than glucantime.

Numbers of older people rapidly increase. Therefore it is important to the health of the elderly. Social capital by providing emotional and mental supports plays an effective role in promoting mental health in older people. So this study examines the factors affecting mental health and its relationship with social capital in the older people of Tehran 9 district. This study is a cross-sectional study that was conducted in Tehran 9 district on the older people over 60 years in 2011. 320 participants in this study were selected by multistage random sampling. To assess mental, health General Health Questionnaire (GHQ-28) and to assess social capital, Urban HEART Questionnaire were used. To determine components of social capital, used from exploratory factor analysis. factor analysis determined three factors include individual trust, social cohesion–support and social cohesion-support. That these three components, explained 68.1 percent of the total variance of social capital. There was relationship between mental health and individual trust and social cohesion and support. But there was not relationship between mental health and social trust and collective relations. Whatever the social capital is more, mental health is also better. On the other hand individuals with better mental health, qualified to social responsibility and role in society. This shows that there is a mutual relationship between mental health and social capital. So the promotion each of them can effect on other.

Numbers of older people rapidly increase. Therefore it is important to the health of the elderly. Social capital by providing emotional and mental supports plays an effective role in promoting mental health in older people. So this study examines the factors affecting mental health and its relationship with social capital in the older people of Tehran 9 district. This study is a cross-sectional study that was conducted in Tehran 9 district on the older people over 60 years in 2011. 320 participants in this study were selected by multistage random sampling. To assess mental, health General Health Questionnaire (GHQ-28) and to assess social capital, Urban HEART Questionnaire were used. To determine components of social capital, used from exploratory factor analysis. factor analysis determined three factors include individual trust, social cohesion–support and social cohesion-support. That these three components, explained 68.1 percent of the total variance of social capital. There was relationship between mental health and individual trust and social cohesion and support. But there was not relationship between mental health and social trust and collective relations. Whatever the social capital is more, mental health is also better. On the other hand individuals with better mental health, qualified to social responsibility and role in society. This shows that there is a mutual relationship between mental health and social capital. So the promotion each of them can effect on other.

In vitro fertilization techniques are used for many years. In such methods, if feasible, it is always better to transform a high quality embryo into uterus to enhance the chance of the success. Therefore, a comprehensive research was conducted to identify important factors related to the embryo quality. We considered potential correlation between embryos derived from an infertile couple in our statistical analyses. In addition, possible nonlinear relationships between the factors and the embryo quality were investigated. In this study, after collecting the necessary information, the statistical method of generalized additive models (GAM) has been employed to determine any nonlinear relationship between quantitative exploratory variables and the response. Then, the results were used to analyze the data using the Generalized Estimating Equation (GEE) technique. Such model can handle correlation which may present among infertile couple embryos. Finally, important factors related to the embryo quality of in-vitro fertilization by intra-cytoplasmic sperm injection methods were identified. Based on results of the GEE, linear relationships of drugs, type of infertility, and polycystic ovary syndrome was statistically significant on embryo quality. Interestingly, after examining the nonlinear relationships with GAM, in addition to the above variables, smoking status, sperm motility, and uterine factor were also shown to be significant. Since observations on a single subject in fertilization techniques are correlated and the relationship between factors and outcomes of fertilization may not be linear, the usual methods of GAM should incorporate the potential intra-cluster correlation using models such as the GEE. Our results suggest significant effects of tobacco use, drugs, polycystic ovarian syndrome, type of infertility, and sperm motility on the embryo quality. Sperm motility has non-linear effect on embryo quality resulting from in vitro fertilization and improved the overall model fit.