فهرست مطالب

Shiraz Emedical Journal - Volume:18 Issue: 6, 2017
  • Volume:18 Issue: 6, 2017
  • تاریخ انتشار: 1396/03/16
  • تعداد عناوین: 5
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  • Reza Valizadeh, Yousef Veisani, Ali Delpisheh *, Sattar Kikhavani, Ali Sohrabnejad Page 1
    Background
    Previous reports on the prevalence of mental disorders in Iran indicated a high prevalence of psychotic disorders in both male and female prisoners.
    Objectives
    In this systematic review, we aimed to assess the prevalence of major depression in Iranian prisoners. We also used meta-regression and subgroup analyses to explore sources of heterogeneity in final enrolled studies.
    Methods
    Relevant studies published in English databases (PubMed, Scopus, Google scholar and ISI) and Persian databases (Magiran, Medlib, SID, and IranMedex) were systematically searched until August 2015. Heterogeneity was assessed by I2 statistics and using meta-regression to explore possible heterogeneity. The random effects models were performed for meta-analysis of the final studies using the Stata software version 11.2.
    Results
    The pooled sample sizes included a total of 1708 prisoners. Data were meta-analyzed using random-effects models. The pooled prevalence of major depression was 42% (95% CI: 26.0% - 58.0%). Overall, 44% (95% CI 26 - 61) of male prisoners and 33% (95% CI 26 - 58) of female prisoners were diagnosed with major depression. Anxiety disorder had the highest prevalence (56.3%), followed by mood disorders (34.6%). Antisocial personality disorders were diagnosed in 24.0% of the participants and borderline disorders in 7.1%.
    Conclusions
    High levels of major depression are constantly reported in prisoners in Iran and the results of this study also confirm it. Further research can also be conducted to explore whether the prevalence of mental illnesses is high among prisoners in Iran.
    Keywords: Prisoners, Mental Health, Major Depression, Meta, Regression, Iran
  • Hossein Jenaabadi, Amir Hossein Jahangir* Page 2
    Background
    Addiction is a multidimensional phenomenon that causes irreparable damages to an individual as well as community structure. Despite enormous efforts made, this phenomenon has not diminished. Therefore, the present study aimed to compare the effectiveness of mindfulness-based group therapy and methadone maintenance therapy in improving the psychological symptoms among opioid-dependent patients.
    Materials: This was a quasi-experimental study. The sample of this study included 57 patients (each group included 19 individuals) using the convenience sampling method among all those who referred to addiction treatment centers. The tools applied were the clinical interview and the symptom checklist for mental disorders. The obtained data was analyzed using the repeated measures analysis of variance (mixed).
    Results
    The results indicated that although both mindfulness-based group therapy and commonly used treatments improved the psychological symptoms among the opioid-dependent patients, the mindfulness-based group therapy was more effective in this regard and it significantly led to an increase in the level of mental health among the opioid-dependent patients after coming off the drugs. Moreover, the results revealed that the effectiveness of these methods could also be observed in the follow-up period.
    Conclusions
    According to the results, the mindfulness-based group therapy, compared to the methadone maintenance therapy, was more effective in decreasing risk behaviors among the opioid-dependent patients.
    Keywords: Addiction, Narcotics, Mindfulness, Psychological Symptoms
  • Maryam Khooshideh, Javad Rahmati, Batool Teimoori * Page 3
    Objectives
    The study aimed to compare the efficacy and side effects of intravenous magnesium sulfate (MgSO4) and oral nifedipine for inhibition of preterm labor.
    Methods
    This randomized controlled trial was performed on 220 women with preterm labor between 32 and 34 weeks of gestation who were randomly assigned to receive either MgSO4 or nifedipine. The primary outcome was inhibition of preterm labor, defined as prevention of delivery for 48 hours with inhibition of uterine contraction, and the secondary outcome was maternal side effects.
    Results
    From 220 patients, 110 received nifedipine and 110 received MgSO4. There were no differences in suppression of labor pain in 24 hours and 48 hours between the two groups. Also, there were not statistically significant differences in one-minute and five-minute Apgar scores, neonatal respiratory distress syndrome, and NICU admission between the two groups. Maternal hypotension was higher in the nifedipine group, but the difference was not significant (P = 0.08). Dyspnea (P = 0.01) and minor maternal side effects (P ≤ 0.001) were significantly higher in the MgSO4 group than the nifedipine group. Serious maternal adverse effects and severe hypotension were not seen in any of the groups.
    Conclusions
    Nifedipine is as effective as MgSO4 in arresting labor and delaying delivery for 48 hours. However, nifedipine is associated with significantly fewer maternal adverse effects.
    Keywords: Magnesium sulfate, Nifedipine, Preterm Labor, Maternal Adverse Effects
  • Alireza Shahab Jahanlou *, Kamiar Kouzekanani Page 4
    Background
    One of the popular indicators of developing serious health conditions is the waist-to-hip ratio (WHR). The appropriate WHR cutoff points are reported differently in the US department of health and human services (US-DHHS), the world health organization (WHO), and the Asian studies.
    Objectives
    The current study aimed at comparing WHR cutoff points for a large sample of Southern Iranian adults with 2 standard procedures and Asian studies.
    Methods
    In the current cross sectional study, data were collected from 16 341 adults within the age range of 20 to 70 years. Body compositions were determined by the bioelectrical impedance analysis method (BIA). Sensitivity, specificity, positive predictive power (PPV), negative predictive power (NPV), and receiver-operating characteristic (ROC) curves were used to meet the objectives of the investigation
    Results
    The sensitivity and NPV in both classifications were higher in females compared to males. For females and males in both classifications, increase in age was associated with increase in the sensitivity and NPV. In all, the WHO classification was not a good indicator of obesity in males. The US-DHHC was the best to correctly classify the obese or non-obese subjects in various age groups.
    Conclusions
    The suitable cutoff points for Iranian males and females were 0.88 and 0.83, respectively similar to those reported in Southeastern Asian studies. The recommended cutoff point for Iranian males was similar to those reported for Arab males; but the recommended cutoff point for Iranian females was different from that of Arab females. Both the WHO-WHR and US-DHHS classifications were effective to detect obesity among all females. Neither was effective to detect obesity among males under 40 years old.
    Keywords: Obesity, Overweight, Waist, to, Hip Ratio
  • Koroush Saki, Ali Mohammad Varzi *, Khalil Momeni, Zahra Khodakaramifard, Morteza Arab Zouzani, Habib Jalilian, Ghasem Rajabi Vasokolaei Page 5
    Background
    Nowadays, the medical tourist industry is one of the most profitable industries around the world. Countries try to attract more medical tourists to take advantage of its benefits. The purpose of this study was to investigate the perspective of tourists (patients and attendants) regarding services provided by hospitals of Lorestan University of Medical Sciences.
    Methods
    This qualitative study was conducted using content analysis approach to explore the determinants of medical tourists’ satisfaction in Lorestan, Iran. First, data were analyzed and studied extensively. Next, breaking down the analyzed texts into smaller chunks, the contents and themes, as the smallest units, were extracted, coded, and categorized. In some cases, quotations from participants were brought for basic and minor themes of the study. Extracting basic, internal themes as well as categories were done by 2 researchers, independently.
    Results
    The most important quoted problems at the provincial level in hospitals included personnel, equipment, and medical and welfare facilities’ shortage, personnel improper behavior with patients and attendants, inadequate skills of the medical staff, unavailability of personnel, lack of suitable general sanitation, mismanagement and problems of admission and discharge.
    Conclusions
    Attracting tourist’s satisfaction could bring major financial resources, consequently helping to reinforce economical aspect in the provincial scale. Doubtlessly, planning in line with solving existing problems is one of the most important and basic procedures in order to attract health tourists.
    Keywords: Satisfaction, Medical Tourist, Hospital, Iran