javad javaheri

Chemotherapy plays an essential role in the treatment of hematologic cancers. Vincristine is commonly used to treat leukemia in children. However, this drug has many side effects, including acute kidney injury (AKI). Adjuvant therapy with antioxidant agents, such as vitamin E, can be administered to reduce this complication

A randomized clinical trial of leukemia patients receiving vincristine was conducted at Amir Kabir Arak Hospital. The patients were randomly divided into an intervention group (400 mg vitamin E for ten days) and a control group. Creatinine levels, glomerular filtration rate (GFR), and acute kidney injury were measured at baseline, 48 h, and seven days later. Independent t-test and chi-square were used to compare data.

This study aims to investigate the potential effect of vitamin E supplementation in reducing acute kidney injury associated with vincristine treatment in patients with leukemia.

Thirty-six children with leukemia, 47.2% of whom were girls, were equally divided into intervention and control groups. The essential characteristics of the two groups were not significantly different. The creatinine level at baseline (0.60±0.08 vs. 0.61±0.12 mg/dl), 48 hours (0.60±0.09 vs. 0.61±0.10 mg/dl), and seven days (0.66±0.16 vs. 0.66±0.13 mg/dl) were lower for the intervention group than the control group, but this difference was not statistically significant (P>0.05). In contrast, the GFR at baseline (92.96±17.87 vs. 91.53±13.46 ml/min/1.73 m2), 48-hour (92.82±18.27 vs. 85.35±15.25 ml/min/1.73 m2), and seven days (90.86±17.84 vs. 85.05±14.41 ml/min/1.73 m2) were higher in the intervention group than in the control group. However, this was not significant. Finally, only one patient in the control group developed AKI, while no cases of AKI were observed in the intervention group.

Vitamin E’s impact on AKI reduction in patients with leukemia was not statistically significant. However, it positively affected creatinine and GFR levels in the intervention group. In addition, no AKI cases were observed in the intervention group.

Nocturnal enuresis and migraine are common disorders among children, each having a major impact on the health and life status of the children and their families. In several children, these two disorders have also been observed together. Accordingly, this study evaluates the relationship between migraine and nocturnal enuresis by examining the frequency of migraine in children with nocturnal enuresis.

In this analytical cross-sectional study, the experimental group includes children with nocturnal enuresis, who were diagnosed by a pediatric nephrologist. The control group is comprised of children without nocturnal enuresis. In both groups, the frequency of migraine headaches diagnosed by pediatric neurologists was checked and finally, the frequency obtained in the two groups was compared. The sample size was 47 people for each group. Information analysis was done through analytical statistics, including tables and statistical charts and their analysis. Independent t-test, the chi-square test, the Fisher test, and if necessary, equations were used to analyze the non-parametric data.

The distribution of frequency between gender and nocturnal enuresis was the same in two groups (57.4% male and 42.6% female). Also, the mean age in the patient category was 7.6±2.3 years and in the healthy category was 8.3±2.6 years. The frequency distribution between having migraine, migraine with aura, the number of times experiencing headache, and family history at the time of admission were the same in the two groups.

In conclusion the frequency of migraine, migraine with aura, the number of times experiencing headache, and family history of migraine were the same in the two groups Keywords:

Background & aim:

 In Intensive Care Units (ICUs), several systems are used to predict patient mortality. In this study, the relationship between the Apache 2 and PSI scores with the length of stay and mortality rate of Covid-19 patients admitted to the ICU was investigated.

This cross-sectional analytical study was conducted on patients admitted to the ICU. In order to collect information, the PSI and Apache 2 tools were used. After obtaining a referral from the university's research vice chancellor, the hospital archives unit was referred. Then, the data required for the Apache 2 tool, the PSI tool, and demographic characteristics related to the first 24 hours of admission to the ICU were collected from the hospital's files and HIS. Information related to the time of death, length of stay, and patient transfer were also recorded.

Of the 486 investigated patients, the mean and standard deviation of age was 62.76 ± 18.1. In addition, 46.7% of patients were female (227 patients) and 53.3% (259 patients) were male. The mean duration of hospitalization in the ICU was 7.15 ± 4.6 days (minimum 1, maximum 27 days). Furthermore, 21% (102 patients) were intubated at the time of examination. Finally, 51.9% (252 patients) were discharged from the ward and 48.1% (234 patients) died. In a recent evaluation, it was observed that the Apache 2 score had a statistically significant relationship with patient mortality, and the mean and standard deviation of the score were higher in deceased patients (P = 0.000). This tool can also predict the mortality rate of Covid-19 patients by 72.4%. The Apache 2 score was related to the patient's age and intubation status (P = 0.001), but it was not statistically significantly related to gender and length of hospitalization (P = 0.905). The PSI score had a statistically significant relationship with patient mortality, and the mean and standard deviation of the score were higher in deceased patients (P = 0.001). The PSI score also had no statistically significant relationship with length of hospitalization (P = 0.581). This tool can predict the mortality rate of Covid-19 patients by 66%. Also, according to the results of the recent evaluation, length of hospitalization was not related to the patient's age, gender, intubation status, and initial level of consciousness.

According to findings, the use of the Apache 2 tool in the admission of patients with Covid-19 to the ICU had a more accurate prediction than other tools and could greatly contribute to the optimal use of ICU beds.

A negative correlation has been seen between serum testosterone levels and glycosylated hemoglobin. L-arginine reduces serum glucose and cholesterol levels in diabetes. Therefore, this study aimed to determine the effect of L-arginine on sexual function and hypogonadism.

In this clinical trial study, 50 men with type 2 diabetes and symptoms of hypogonadism were randomly divided into two groups. Demographic and laboratory information and International Erectile Dysfunction Questionnaire 5 (IIEF5) were completed in both groups. Then, the first group received an oral L-arginine 3 gram single dose per day for 8 weeks, and the second group received a placebo vial for 8 weeks. We compared the primary outcomes, including total and free testosterone plasma levels, as well as secondary outcomes, such as Sexual function and symptoms of hypogonadism between the two groups.

In the L-arginine group, after 8 weeks of intervention, sexual performance (36.43 ± 3.84 to 28.44 ± 11.4, P = 0.001) and free testosterone plasma level (19.16 ± 0.07 to 22.21 ± 1.25, P = 0.001) (79.6 ± 35.2 to 78.8 ± 11.3, P = 0.031) significantly increased While there were no significant changes in the placebo group (P ≥ 0.05). side effects (P ≥ 0.05). did not show significant differences between the two groups.

Oral L-arginine is effective on sexual performance and symptoms of hypogonadism in type 2 diabetic men. Therefore, L-arginine can be a suitable alternative to testosterone in the treatment of hypogonadism in men with type 2 diabetes.

Divorce, as one of the most important social phenomena, has many psychological  complications, among which is depression. Continuity of depression can affect a person's quality of life. Hence, it is necessary to adjust and treat these complications through various psychotherapies. As such, the aim of this research was to compare the effectiveness of cognitive-behavioral therapy and interviewing on divorced women’s depression.

The current study used a semi-experimental pre-test and post-test design. The statistical population consisted of 260 divorced women aged between 20 to 50. Sixty of the aforementioned women were selected based on the inclusion criteria and then randomly assigned to three groups of cognitive-behavioral therapy, motivational interview therapy, and control group. The instrument for data collection was Reyes and Patterson's Anxiety Sensitivity Questionnaire. For the experimental groups, 12 treatment sessions of 75 minutes were held. Before the interventions and at the end of the study, people in all groups filled out the depression questionnaire. Data were entered into the SPSS software version 25 and then were analyzed.

There was a significant difference between the three groups of cognitive-behavioral therapy, motivational interview, and the control group in the comparison of the mean score of depression variables (p<0.05). Also, there was a significant difference in the post-test stage (p<0.05) in the one-by-one comparison of the cognitive-behavioral therapy and motivational interview therapy groups with the control group.

The findings indicate that cognitive-behavioral therapy and motivational interviewing are effective in reducing depression in divorced women. It is suggested to use this method along with other psychological and pharmaceutical interventions in order to reduce depression in divorced women as a clinical intervention.

 Diabetes is a chronic metabolic disease that impairs plasma lipid levels and prone a person to cardiovascular diseases. Since standard therapies in diabetes control fail in many patients, using herbal medicines in these patients has been considered.

 The present study aimed to evaluate the effect of Nigella sativa (NS) seed powder on blood sugar and fat profile in type 2 diabetic patients.

 Eighty patients with type 2 diabetes were recruited and randomly assigned into control and experimental groups. The experimental group received a capsule containing Nigella sativa seed powder for two months, and the control group received a placebo. Blood glucose and lipid profile data were statistically analyzed at the end of two months. This study was conducted in diabetic clinic of Khomein City during the 2019 - 2020 year. The groups were compared using a repeated measures analysis of variance (ANOVA) test.

 The mean age of patients was 53.82 in the experimental group and 55.12 in the control group. In comparison between the two measurements before and after the interventions, the variables glycosylated hemoglobin (HbA1c), cholesterol (Chol), and high-density lipoprotein (HDL) showed a statistically significant difference (P = 0.0001). The interactive effect between the control and intervention groups before and after the interventions was statistically significant for the postprandial glucose (PPG) variable (P = 0.035).

 The results of our study showed that the consumption of NS seed in diabetic patients could change the fat profile and reduce hemoglobin HbA1c, which indicated that Nigella sativa seed had been effective in reducing blood sugar over time.

Employees are among the least active groups in society. The aim of this study was to investigate the effect of comprehensive interventions to provide appropriate conditions in the workplace in order to increase physical activity or exercise by using the transtheoretical model of change (TTM).

The present study was a workplace-based semi-experimental intervention conducted in 2013 with the participation of 90 employees of the Vice-Chancellor of Health in Markazi Province, Iran. In group discussion sessions with employees, the factors affecting sedentary lifestyle and strategies to increase it were extracted. After prioritization, the interventions to change the staff's physical activity were performed within eight weeks. Before and after the interventions, the number of steps taken with the help of a pedometer and the rate of behavior change was measured by a questionnaire of structures of the trans-theoretical model. Finally, the collected data was analyzed by SPSS software version 20 and with the help of paired t-test, chi-square, and analysis of variance.

The mean (SD) age of participants was 47.4 (12.9)years. The average number of steps before the intervention was 6964, which increased to 9369 after the intervention (P<0.001). Before the intervention, 12.5% of participants had at least 10,000 steps per day, which reached 39.9% after the intervention (P<0.001). Before the intervention, only 20.5% of participants had regular physical activity during the action and maintenance phase, which increased to 51.3% after the intervention (P<0.001).

The results of this study showed that workplace adaptation interventions, in order to change the physical activity of the staff, by TTM changed model and pedometer, have been effective in increasing their physical activity.

Divorce is one of the most important social phenomena that depends on many factors. The purpose of this study was to compare the effectiveness of cognitive-behavioral therapy and motivational interviewing on symptoms of anxiety sensitivity in divorced women.

The current study was a quasi-experimental interventional design. The statistical population consisted of 260 divorced women aged 20 to 50. Sixty of the mentioned women were selected based on the inclusion criteria and randomly assign to three groups, cognitive-behavioral therapy, motivational interview therapy, and control group. The instrument of data collection was Reyes and Patterson's Anxiety Sensitivity Questionnaire. For the experimental groups, 12 sessions of 75 minutes were held. No intervention was done for the control group. Before the interventions and at the end of the study, people in all groups filled out the anxiety sensitivity questionnaire. The data was analyzed using SPSS version 25 software and analysis of covariance (ANCOVA).

There was a significant difference in the mean score of the anxiety sensitivity variable between the three groups of cognitive-behavioral therapy, motivational interviewing and the control group (p<0.05). Also, in the one-by-one comparison of the cognitive-behavioral therapy and motivational interview therapy groups with the control group, there was a significant difference in the post-test stage (p<0.05).

The findings indicate that the methods of cognitive-behavioral therapy and motivational interviewing are effective in reducing anxiety sensitivity in divorced women. It is suggested to use these two methods along with other psychological and pharmacological interventions in order to reduce anxiety sensitivity in divorced women as a clinical intervention.

 Considering the high prevalence of diabetes mellitus and its effect on the quality of life (QoL) of patients which can lead to low self-care and increased risk of disease complications, this study aims to assess the effect of a self-care training program based on temperament modification on the QoL of patients with type 2 diabetes (T2D).

In this quasi-experimental study, 110 patients with T2D were selected by a convenience sampling method and were randomly divided into two groups of intervention and control using the random number table. After obtaining informed consent from them, they completed a demographic from and the World Health Organization Quality of Life-BREF (WHOQOL-BREF) questionnaire, and their temperament was diagnosed by a doctor expert in Iranian traditional medicine. The intervention group received four sessions of self-care training based on temperament modification each for 45 minutes. The control group received routine treatment without any intervention. Then, they completed the WHOQOL-BREF questionnaire again three months after the intervention. Data were analyzed in SPSS software, version 22 using chi-square test, paired t-test, and independent t-test. The significant level was set at 0.05.

Before the intervention, there was no significant difference in the quality of life score between the intervention (83.2±11.9) and control (85±9.4) groups (P= 0.194). After the intervention, the difference was significant between the intervention (87.7±11.3) and control (85.1±9.5) groups (P=0.044). There was no significant difference in the quality of life score in control group before and after the intervention (P=0.244).

The self-care program training based on temperament modification can improve the quality of life of patients with T2D.

The present study aimed to investigate the potential effects of the combined herbal capsule (CHC), as a nutritional supplement, on glycemic indices (GIs) and lipid profile (LP) of patients with type 2 diabetes mellitus (T2DM).

Following a randomized, single-blind, placebo-controlled clinical trial, the current study was conducted on 80 cases with T2DM who were randomly assigned into two groups of treatment (CHCs; n = 40) and control (placebo; n = 40). Both groups received the intervention (500 mg capsules) twice a day for three months, without changes in the previous dose of oral anti-hyperglycemic drugs. The GI and LP levels were measured before the intervention and three months later to investigate the potential efficacy of the interventions.

For those in the intervention group, the mean GI [i.e., fasting blood sugar, two hours postprandial (2hpp), and HbA1c] was significantly different after 3 months (P < 0.05). The GI- and LP-related outcomes (TG, LDL-C except for TC) were improved after 3-month of receiving the intervention compared to the control group; however, the observed improvement was no statistically significant (P > 0.05). The HDL-C level was also significantly improved in the intervention group compared to the control group (P < 0.05).

This study demonstrated that receiving CHCs could improve GI and LP levels (TG, LDL-C, and HDL-C, except for TC), which indicates its potential to control T2DM. Moreover, no significant side effect was observed in the intervention group. It can be argued that the use of CHCs, as adjuvant therapy, in combination with conventional hypoglycemic and lipid-lowering drugs, as well as following a modified lifestyle, not only can significantly enhance glycemic control but also may prevent T2DM complications.

Iodine deficiency is known as a major nutritional health problem in Iran. The aim of this study was to evaluate iodine salt intake, salt storage, and urinary iodine in households of Markazi Province, Iran, in 2014.

In this cross-sectional analytical study, 440 households of 11 cities in Markazi Province in 2014 were selected through a multistage random sampling. A structured questionnaire was used to collect information about the type of salt used and awareness about salt storage. Parameters of salts were measured by taking the samples from household salt. Simultaneously, urinary iodine was measured via samples from the elementary students in the household. Data were analyzed using SPSS software.

Of 440 households, 225 households (58.0%) used iodized refined salt. Approximately, 60.0% of households were aware of the correct way of salt storage. The mean urinary iodine concentration (UIC) of children was 19.2 ± 18.3 μg/l. The average iodine concentration in household salts was 29.3 ± 3.8 ppm and only half of the salt-producing companies had iodine levels above 30 ppm. The average of salt heavy metals at the level of production and consumption was at a standard level.

The average iodine concentration of salts was less than the standard level. Therefore, in the absence of proper monitoring of the cycle of production and supply of iodized salt, there is a possibility of recurrent iodine deficiency complications in Markazi Province. Enhancing public awareness about salt storage for maintaining the quantity and quality of iodine is recommended.

Stroke is one of the major causes of disability and mortality in Iran. Therefore, it is of critical importance to know the factors affecting the effective management of acute stroke for better prevention and treatment of stroke.

The present study aims at investigating the risk factors associated with prognosis in patients with acute strokewho were registered in the "724" stroke management registry system at Amir Al-Momenin Hospital, Arak, Iran.

This retrospective observational study included all acute stroke patients who were registered in the "724" stroke management registry system at Amir Al-Momenin Hospital, Arak, Iran, from April 2017 to April 2019. Data were analyzed in SPSS software (version 23) through the Chi-square test, Fisher's exact test, Mann Whitney U test, and logistic regression.

This study investigated139 patients with acute stroke registered in the "724" stroke management registry system at Amir Al-Momenin Hospital, Arak, Iran, from April 2017 to April 2019. The mean age of the patients was 62.91±13.31 years, and the majority of the cases were male (n=77; 55.4 %). Totally, 104 (75.4%) and 31 (22.3%) patients had hypertension and diabetes, respectively. In-hospital mortality showed a statistically significant relationship with a history of stroke, brain computed tomography scan results and high National Institutes of Health Stroke Scale (NIHSS) at baseline (P<0.05).

High rate of hypertension among stroke patients highlights its significance as an important modifiable risk factor for stroke. Attention to these risk factors is essential for the primary prevention of stroke. History of stroke and NIHSS score at baseline≥8 associated with poor outcome at discharge.

Shigella species are one of the main causes of dysentery. This study aimed to determine the frequency and antibiotic resistance patterns of Shigella species isolated from infectious diarrhea samples in khomein, Iran. A total of 54 infectious diarrhea samples obtained from patients were included in this descriptive cross-sectional study from June 2017 through November 2018. The infectious diarrhea samples were cultured to XLD, MacConkey agar and GN Broth. The phenotypic antibiotic resistance profiles were determined. This study with research ethics code IR.ARAKMU.REC.1396.307 has been approved by research ethics committee at Arak University of Medical Sciences. Out of 54 infectious diarrhea samples, 11 (20.3%) with Shigella spp were identified using culture media. S. sonnei 9(81.8%) and S. flexneri 2(18.1%) were the single species found. The highest antibiotic resistance rates were found for cotrimoxazole 11(100%), ampicillin 10(90.9%), cefixime, cefotaxime and ceftriaxone 9(81.8%). In this study, 8 (72.7%) of the isolates were ESBL and 1 (9%) were AmpC positive. This study showed that Shigell spp are the main bacterial agent causing dysentery in infectious diarrhea samples in khomein, Iran. This should be taken into consideration by infectious specialists especially during empirical treatment.

Asthma is the most common cause of recurrent wheezing, cough and dyspnea in childhood. Delay in diagnosis and lack of appropriate treatment can cause sustained changes which decrease respiratory capacity of children in future. Therefore, identifying the symptoms relating to asthma is the key for timely diagnosis and treatment of this disease. This study was done to investigate asthma incidence in khomein and compare it to other cities of Iran susceptible to asthma, including Tehran. The present study was a descriptive cross-sectional one based on standard questionnaire of International Study of Asthma and Allergies in Childhood (ISAAC). For conducting this study, 1621 students of first grade in some primary schools and junior high schools of khomein were selected through nonrandom sampling and census and were evaluated during 2015-2016. Both groups were studied and evaluated in terms of being affected by asthma and its severity (current and previous wheezing ,night-time cough, talking limitation due to coughing or wheezing, exercise-induced wheezing, nocturnal awaking due to cough). Results were analyzed through the chi-square test. The asthma diagnosed in Khomein students by the physician during the study was 3.5% while 73.2% of the children under study had at least one asthma symptom. One eighth of the students under study had severe asthma. Comparing with polluted Tehran and northern cities of Iran, Asthma symptoms incidence was higher in khomein where the humidity and industrial pollution is less than in those cities and the asthma cases diagnosed by physicians were much fewer than expected asthma incidence.

The aim of this study was to investigate the characteristics and personality dimensions extraversion vs. introversion, neuroticism versus emotional stability characteristics with adherence in patients with type 2 diabetes. In this cross-sectional study, 100 type II diabete's patients were recruitment by convenient sampling method. Patients checked-out revised questionnaire of Eysenck Personality (short form) and questionnaire to treatment adherence.The data were analyzed by Spearman correlation test and a linear regression model and for spss software was used for data analysis. there was a significant inverse correlation between the personality neuroticism traits and adherence and a significant positive correlation between personality traits - emotional stability and consistency of treatment of modes. There was not correlation between introversion and extroversion. The results of this study emphasize the influence of personality traits, emotional stability, neuroticism on the adherence and treatments follow-up among diabetic patients.

This research focuses on studying computer games industry in Iran. Attempts have been made to analyze the problems of this industry to pathologically study and identify hurdles in the way of its growth. Hence, after reviewing the related literature in the field of system theories, game industry and its condition in Iran are briefly introduced. In the next step, the viewpoints of experts of this field were collected through qualitative methods such as interview and Delphi technique and through factor analysis eleven problems of this industry in internal and external environments were identified.

The major goal of this research is strategy formulation for video games field in Iran oriented to necessary strategies for implementation in upstream institutions; Strategies in order to resolve existing cultural and religious issues in this field especially concerned with cultural and religious influences on university students as a very large group of audiences of this industry. This research is an applied research that uses qualitative methods. Methods that have used in this research include interview with experts, Delphi technique and SWOT analysis. Findings of this study include those strengths and weaknesses, and also opportunities and threats in videogames industry environment of Iran which is related to cultural issues. Obtained factors include 1 strength, 4 weaknesses, 3 opportunities and 6 threats. Regarding to these factors and use of SWOT analysis, 8 strategies are obtained that generally include subjects such as talent scouting and education, facilitating legal steps, distribution systems improvement, establishment of incubators and venture capital funds. As mentioned above, 8 strategies were obtained that these strategies should be executed by upstream institutions. These strategies are for facilitating of game companies business. With implementation of those, videogames business in Iran is improved, a field of game production that matches with Iranian-Islamic culture is created, and cultural negative effectiveness trend can turn to positive trend

The prevalence of constipation in childhood is 0.7% to 29.6%. Inorganic causes are considered as the most common cause of constipation in children. Polyethylene glycol (PEG) is the most effective and safest laxatives which is usable in children in the long-term. This study was conducted to evaluate and compare the effect of PEG treatment and probiotic bacilluscoagulans and bifidobacterium and probiotic to enhance the growth of probiotics. In this double blind clinical trial study(interventional study), 120 children aged 2-16 years with chronic functional constipation enrolled the study based on ROME III criteria. The bowels became empty by using liquid paraffin. Then, children were randomly divided into three groups of polyethylene glycol+placebo and Probiotics+placebo and polyethylene glycol+probiotics recipients. After 6 weeks of treatment, treatment success rates between the three groups were compared before and after the study Data analyzed by SPSS 20 software. The results of the study conducted on the three groups for treatment of constipation showed that the effect of polyethylene glycol and probiotic on treatment was considerable before and after treatment; but the levels of effect was similar in the comparison of groups. The simultaneous use of two drugs was more effective than a single drug. Overall, the results of our study showed that concurrent use of polyethylene glycol and probiotics is much more effective in the treatment of constipation.

Prostate cancer is one of the most common cancers among men, that is increasing in incidence and mortality. Considering the epidemiologic trend of prostate cancer, the aim of this study was to investigate the incidence of prostate cancer in the years 2005-2010 in Markazi Province. In this analytical study, which data was derived from the Cancer Registry of Markazi Province, crude incidence per 100 thousand persons and age-standardized incidence in the method of direct standardization using the world standard population were calculated. Data Analysis was conducted using the Cochran-Armitage and winpepi software version 2.1. In this study among 182 patients with prostate cancer in 2005–2010, 144 patients (%79) inhabited in city and others in rural. Regarding age, 16 persons (%8.8) were between 50-60 and majority 84(%46) were 70-80 years old. In the 6- year study, 182 cases of prostate cancer were recorded. Age-standardized incidence rate during the years 2005 to 2010 was respectively: 3.24, 3,3.44,5.05,5.75, 5.61 cases per hundred thousand people which shows an increase in the disease. The highest observed incidence in the age group was above 70. The standardized incidence rate of prostate cancer in Markazi province in comparison with the world, particularly developed countries, is much less that can be due to lack of screening programs or the incomplete records.

Having high knowledge in patients is not sufficient for disease control and it is necessary to get more skills and capabilities that could be helping in confronting with diabetes associated stresses. This study is aim to assess the relationship between coping styles approaches with adherence to treatment in type 2 diabetic patients. In a cross sectional design 100 type 2 diabetic patients were selected by convenience route. Folkman and Lazaros as well as adherence to treatment questionnaires were filled by participants. Data was analyzed by SPSS software version 16، spearman correlation test and linear regression model were used for inferential statistics. Problem and excitement oriented subscales were significant correlation. The correlation between problem oriented subscale and adherence was positive and significant (P<0. 05) so that regression model showed as this subscale increase the adherence was increasing as well. The correlation between excitement oriented subscale and adherence was negative and significant (P<0. 05) so that regression model showed as this subscale increase the adherence was decreasing. The results emphasized that there is significant correlation between copying styles and adherence to treatment in type 2 diabetic patients.

Some patients with Coronary Artery Disease (CAD) have no well-known risk factors of this disease, but are diagnosed with cardiovascular events. The present study aimed to assess the association between Apo A1 and ApoB and the severity of CAD and determine whether these parameters are better predictors of Ischemic Heart Disease (IHD)..

In this case control study, 271 individuals who were suspicious of having CAD and had been referred to Arak Amir-al-Momenin hospital underwent coronary angiography. Based on the results of angiography, the participants with presence or absence of coronary artery stenosis were allocated into the case and the control group, respectively. The severity of CAD involvement was determined by Gensini score. The data were entered into the SPSS statistical software and analyzed through parametric and non-parametric tests, sensitivity analysis, and logistic regression..

The results revealed no significant correlation between apoA-1 and severity of CAD involvement (GS) (r = 0.017, P = 0.797). However, a significant correlation was found between apoB and GS (r = 0.127, P = 0.047). Logistic regression model showed ApoB, sex, DM and, FH as the only proper predictors of IHD (P < 0.048, P < 0.002, P < 0.040, and P < 0.001, respectively). In comparison to angiography for diagnosis of CAD, ROC analysis represented ApoB as a more useful predictor (P = 0.023)..

In addition to measurement of conventional parameters for assessing CAD high risk groups, according to the results of this study using ApoB would be resonable as well. Further investigations are recommended to clear the problem..

Early detection and treatment are crucial to prevent mental retardation in congenital Hypothyroidism (CH). The aim of this study was to evaluating of screening program of CH in Markazi Province. In cross sectional descriptive study we used recorded data in Markazi province health center. From 2006 to 2012،127112 newborns were screened by measurement of serum TSH level by heel prick. Neonates who had blood TSH≥5MIU/L were recalled for more evaluation. Neonates with confirmed hypothyroidism underwent treatment. From127112 screened neonates، 414 were diagnosed as CH patients (both permanent and transient). The prevalence of CH was. Recall rate was 4. 8%. In 94. 4% of patients، treatment were begun before the 40th day of life. The coverage percent in the province was 100% from the second year of the program. Recall rate and the incidence of CH were higher than those in other studies، both in Iran and other countries. The mean age of treatment initiation and coverage percent were in favorable range.

Traditionally levels of cholesterol and triglyceride are used to identify individuals at risk of coronary artery disease (CAD). The aim of this study is examining the association of Apo A1 and ApoB with severity of coronary artery disease and whether these parameters are better predictor of CAD.

This is a cross- sectional study. All patients that referred to ARAK amirallmomenin hospital and enrolled for coronary angiography was entered to study. Before angiography and after gathering informed consent، levels of apo A1 apoB، cholesterol، TG، LDL، VLDL، HDL and FBS were measured. The results of coronary angiography were reviewed by two experienced cardiologist separately. Severity of coronary artery disease involvement was determined by Gensini score (GS)، the data were analyzed with statistical methods by SPSS software.

There is a statistically significant correlation Between apoB and GS (r=0/127، p=0/047). Logistic regression model showed that among predictors for CAD entered model eg gender، age، cholesterol، TG، HDL، LDL، VLDL، apo A1، ApoB and ApoB/Apo- A1 ratio، only ApoB and gender were proper predictors of coronary artery Disease (CAD) (p=0/002،، p=0/001). In comparison with angiography for diagnosis of CAD، ROC analysis represent that using ApoB can be useful test (p=0/047).

According to result of this study، using ApoB in addition to conventional parameters for assessing the patient at risk to having CAD would be reasonable and could be an independent risk factor for CAD.

Training and continuous dynamic communication between patients and health professionals in chronic diseases like diabetes, is important. The aim of this study is to evaluate the effects of diabetes self-care group education and nurse- telephone follow-up on glycemic control and compliance with treatment orders in patients with type 2 diabetes attending to diabetes clinic in khomein. In this clinical trial, 62 patients with type 2 diabetes who attending to the diabetes clinic selected and were randomly assigned to experiment and control groups. Self-care group education was applied for case group (n = 31) and they were followed up using telephone calls for 12 weeks by a nurse. The control group (n = 31) received the conventional management. Demographic characteristics, compliance with treatment recommendations (diet, drug use, exercise) and blood glucose control indices were recorded before and after interventions. Data were analyzed by SPSS software version 16 using independent t-test, paired t-test, Chi-square test, non-parametric tests, mixed model (ANOVA + repeated measure) and ANCOVA. The mean age of intervention and control groups was 50.9 ± 7.3 and 55.1 ± 10.1 years, respectively. Blood glucose indices (FBS, 2 hpp BS, Hb A1C) were improved in both case and control group after intervention but it was only statistically signifi cant in case group (P > 0.0001). During study, percentage of patients with very good compliance in control group decrease from 12.5% to zero (0%), whereas in experiment group these amounts increase from 6.5% to 90.3% (P > 0.0001). According to the results of the current study self-care group education and 12 weeks follow-up by a nurse using telephone causes significant improvement in metabolic parameters and adherence to treatment recommendations in diabetic patients.

Brucellosis is a zonosis that can be transmitted between species from animals to humans or from humans to animals، which is still a major health and economic problem. The main preventive strategy for ­brucellosis is to educate rural ranchers on the basis of Precede framework. ­We aimed to study the effect of educational intervention program based on Precede Model and its main components on preventive behaviors to reduce Brucellosis in the rural district of Khomein. In this pre-experimental randomized controlled study، the samples were 400 adult men of rural district of Khomein city randomly allocate d to case and control groups. Data gathering instrument was a questionnaire based on Precede framework. Reliability of the questionnaire through the internal consistency test on the pilot phase was approved on 25 individual and the validity was confirmed by face validity. The intervention، based Precede framework، was a package of three 60-90 minute sessions conducted weekly. The subjects were followed for three months and the data analyzed by independent T-­test، paired T-­test، analysis variance with repeated observations. After intervention، the mean scores of predisposing­ (knowledge and attitude)، reinforcing and enabling factors in case group is different significantly from that in control group (p<0. 05). Planning and implementation­ of health education intervention via Precede framework could be positive in increasing preventive behaviors to reduce brucellosis incidence.