مجله علوم پزشکی رازی
سال بیست و چهارم شماره 8 (پیاپی 161، آبان 1396)

Road Traffic Accidents (RTA) is a major public health problem in the world. The RTAs patterns are different in various countries which require taking specific approach es and strategies. The purpose of this study was to use Growth Mixture Model (GMM) to study the pattern of RTAs death rate worldwide.
In this longitudinal study, RTAs death rate data of 193 countries from 2007, 2010 and 2013 were extracted from the World Health Organization reports. In order to investigate the RTAs growth trajectory, linear and nonlinear Latent Growth Models (LGM) were used and compared to each other. Finally, the GMM was fitted to identify and classify countries based on RTAs death rate patterns. Statistical analyses were conducted by Mplus 6.12.
The nonlinear LGM fitted better than the linear model. According to nonlinear model, the estimated RTAs rate trend was downward in the first three years and then the rate changed to upward. By using GMM, seven subgroups with different RTAs death rate patterns were determined.
From 2007 to 2013, the RTAs death rate in the world started to decline and then increased. Based on death rate growth trajectories, world countries classified into seven subgroups with various patterns. Therefore, in order to reduce RTAs death rate in the world different approaches need to be considered for each subgroup.

breast cancer is a high stressed disease which social adjustment is the most effective way to encounter it in this group of patients. Having Knowledge toward social adjustment has important role in its improvement; we try to show this fact in this research.
This study has descriptive design and 83 women with breast cancer were select for this research in Boukan city. For gartering data we used of social adjustment’s questionnaire which contained 45questions in 7 domains its validity was obtained by content validity and its reliability was 0.89 by Alpha cronbach test. Data were analyzed by ANOVA test and SPSS software.
result showed the average of age of participants was 42.32, 57.14%of patients were house keeper.39.28 had Diploma degree.64.28 of them had income equal with their spending and 57.14% of patient’s disease was recognized less than 6 months. The average social adjustment’s score was 125.28.53.Assesing varies domain showed that patients have the least problem in their role as parents 19.18±1.59.but their most problem was with their spouse 15.96±1.14.
by considering low level of social adjustment in breast cancer women, medical managers and nurses should pay attention toward social adjustment in patients with breast cancer and provide essential facility in this field.

Obesity is one of the most important public health problems around the world and is considered as a chronic inflammation. It iswell known that body mass index and abdominal obesity are associated with increased inflammation. Diet plays a major role in regulating chronic inflammation. The aim of this study was to investigate the relationship between dietary Inflammatory index (DII) and obesity in Tehranian women.
This descriptive-analytic cross-sectional study was performed on 198 women referred to health centers of Tehran University of Medical Sciences by cluster sampling. Food intake was measured by food frequency questionnaire and the inflammatory diet index was calculated. Anthropometric measurements in women included measurement of weight, height, and circumference. Disturbing factors were adjusted in last analysis and p The mean age of the subjects was 33.4 years and the mean BMI was 25.1. The distribution of individuals in terms of weight, BMI and waist circumference was significant on tertile of DII. The odds ratio for central obesity in the lowest tertile of the DII after adjustment for confounding light compared to the highest tertile was 0.10 that was statistically significant. But the odds ratio for general obesity was not significant, according to tertile of the DII p=0.2.
Overall, this study suggests that with increased DII, the odds ratio of central obesity is increased. But has no effect on the risk of developing general obesity. Further studies are required to clarify this relationship.

Latent autoimmune diabetes of adults (LADA) is a form of autoimmune diabetes initially managed with oral hypoglycemic agents before becoming insulin requiring. One of the LADA risk factors is family history of diabetes (FHD) that less well understood. Our aim was investigate the influence of FHD on the incidence of LADA compared with those for type 1.
In this cross sectional study, 126 patients participated. Of these, 86 patients had type 2 diabetes and 40 persons were diagnosed with type 1 diabetes. The two groups compared for biochemical, anthropometric and clinical characteristics. The GADA, ICA and IA2A assessed by ELISA technique used for diagnosis of LADA patients. Then, LADA and T1DM patients compared regarding diabetes mellitus family history.
According to the findings this study, 26 (74.28%) patients with LADA and 17 (42.50%) patients with type 1 diabetes had a family history of diabetes. Also, a significant association was observed between family history of diabetes and LADA. Mean concentrations of C-peptide in LADA patients with a family history of diabetes was 0.62±0.22 and in those without a family history of diabetes was 1.05±0.43 ng/mL, showed significant differences (p= 0.001).
Our study indicates that family history of diabetes could be a risk factor for LADA and that the effect of family history may be mediated through a heritable reduction of insulin secretion.

Addiction is a biological, psychological and social disease that due to its progressive nature affects all dimensions of life of the individual, the family and the society. Current research aims at identification and prediction of effective variables on success of addiction treatment among addicts of Alborz Province Addiction Treatment Centers in 2016.
This is a descriptive correlational research. For this study, 400 successful and unsuccessful addicts in quitting addiction were selected using convenience sampling and Krejcie and Morgan Table. Both groups answered to Personality Inventory, Cognitive Emotion Regulation Questionnaire, Alexithymia Scale, Depression Anxiety Stress Scales, Spiritual Attitudes, and Perceived Social Support. Data were analyzed using discriminant analysis through SPSS v. 20.
Findings showed that there were higher means for social support, spiritual attitude, extroversion, agreeableness, conscientiousness, and cognitive emotion regulation strategies among treated samples and higher means for depression, stress, alexithymia, and neurosis among addicted individuals. The differences between groups’ means for all variables at p=0.01 and for acceptance variable at p=0.05 were reported to be significant.
Among 18 predictable variables seven of them which consist of social support, negative affections, alexithymia, spiritual attitude, extroversion, agreeableness, positive reassessment, remained in the model which with the ability of 86.8 per cent can predict the success of addiction treatment.

In Iran, breast cancer is the most common cancers and the first cause of death from cancer. The purpose of this paper was to present accurate educational needs in various women's groups and by providing effective strategies to increase awareness of the different dimensions of the disease, preventing breast cancer, or if it occurs, be discovered and treated at an early stage. These ultimately can reduce the burden of the disease in the community.
This study, using data collected in 2012, was conducted as a cross-sectional study on 10,000 Esfahanian women aged 20 to 65 years. Of these, 9260 women were eligible for the study and the data from the questionnaire were analysed using Latent Class Regression.
The mean±SD age of the subjects in this study was 37.5±11.7 years. In evaluating the factors affecting the identification of risk factors for breast cancer, age variable had very little effect on the placement of subjects at different levels. The chance for women with positive family history of breast cancer in class I and II is 30% higher than class III.
The place of residence of people (urban / rural) had the most effect on the level of awareness of all aspects of breast cancer. Thus, those individuals living in urban areas had a greater chance of being placed at a higher level of aware than rural residents, which could be due to the unjust distribution of wealth and educational, health and medical facilities.

Central body fat is a better predictor than overall body fat for cardiovascular risk factors in both adults and children. Waist circumference has been used as a proxy measure of central body fat; and Waist-to-height ratio has been proposed as an alternative, conveniently age-independent measure of cardiovascular risk. The purpose of this research was to compared waist circumference, waist-to-hip ratio and waist-to-stature ratio in predicting overweight / obese male students.
Subjects were new entrants male students from Ferdowsi University of Mashhad with range of 18-22 years. Height, weight, body mass index, waist circumference, hip circumference, waist-to-hip ratio and waist-to-stature ratio barefoot and with minimal clothing were measured. Data were analyzed by ANOVA test and ROC analysis.
Mean waist circumference, waist-to-hip ratio, waist-to-height ratio in different groups of BMI was significant. Area under the curve for WC (p=0.003) and WHtR (p=0.013) had significant difference, but WHR was not significant (p=0.335).
WC and WHtR are better indices than WHR to detect in overweight and obesity; however WC is the index applicable for clinical practice because it is easier to measure than the other two indices and is low cost.

Surveying the attitude of interns and emergency medical assistants of Hazrat Rasool hospital in Iran about its educational environment.
The research had cross-sectional descriptive method. The statistical population included all interns as well as all emergency medical assistants of Hazrat-e-Rasool Hospital in the 2017 first semester of whom 37 samples were selected by census. In this study, the Persian version of the DREEM questionnaire was used. Descriptive statistical methods such as frequency, percentage, mean graph and standard deviation and analytical statistics such as t-test and Chi-square were used to analyze the data.
The results of study showed that the overall score of the educational environment in the group of assistants was 138.52 and in interns was 99±1.28, which had a significant difference between the two groups (p= 0.001). According to McAleer and Rough's Practical Guide, the average between 101 and 150 indicates that positive points were more than negative.
Decision makers and educational planners need more effort to improve the status quo.

Telemedicine is a new technology used in electronic and digital technology to provide medical and health care to patients who are away from treatment centers. The purpose of this study was to investigate the factors affecting the adoption of this technology in Iranian hospitals.
The present study is a quantitative study that is considered as an applied objective. The statistical population consisted of specialists and experts familiar with telemedicine technology in Iranian hospitals, among them with simple random sampling method 250 were selected as sample and electronic questionnaire distributed among sample members and the collected data were analyzed using the structural equation method.
The results showed that the trust of users and the appropriate infrastructure on the effectiveness of telemedicine had direct effect and the effectiveness of telemedicine is directly associated with the ease of perceived use and the perceived usefulness of telemedicine.
The use of telemedicine technology in Iran is necessary, and in order to deploy and adopt telemedicine technology, it is necessary to have the appropriate technical and communication infrastructure and the trust of users, in order to increase the effectiveness of this technology, we will witness its increasing use and acceptance in hospitals of the country.

Injuries to ACL can be seen with meniscus tear, chondral lesions, and other ligament injuries. This study assesses the epidemiology of ACL injury and concomitant injuries in an athletic population.
From January 2001 to December 2011, athletes with ACL injuries were enrolled in this study. Ultimately, 227 patients, 220 males (96.92%) and 7 females (3.08%), were studied.
Median interval from accident to surgery was 18 months, and the mean of this interval was 21.85 months. Mean age of patients was 25.6 years. 75% of patients had some type of meniscus injury (medial meniscus injury in 52.15%). The most common site of meniscus injury was posterior horn in both medial and lateral meniscus. Chondral lesions were seen in 13.4% of patients, and the highest risk was 4 years after injury. Most chondral lesions (65.5%) occurred in the medial compartment. The ligament most commonly injured in association with an ACL injury was the medial collateral ligament (6.9%). Noncontact sports, especially soccer, were the most common cause of ACL injury (50%).
In this study, we concluded that concomitant injuries with ACL tear will increase with time. Further studies are needed to evaluate the role of early operation (ACL reconstruction) to decrease concomitant injuries.

One of the psychological disorders that theoretically, is not unconnected with a migraine, obsessive-compulsive disorder is that with obsessive thoughts and rituals described, So this study aimed to compare components Obsessive-Compulsive Disorder in migraine sufferers and healthy individuals.

Method this study was causal-comparative and population included all the patients admitted to Khatam hospital in Zahedan during 2015. 105 people of a migraine selected by using Gpower, recognition of neurologists and Ahvaz Migraine Questionnaire. They were compared with 105 normal individuals. The data collection tools were Ahvaz Migraine a headache (AMQ) and obsessive-compulsive disorder (OCI-R) questionnaire’s. Data analyzed by using descriptive statistics and Manova.

Results showed there is a significant difference between the groups with and without migraines in component scores of obsessive-compulsive disorder. So that migraine sufferers in grades washing, ordering, checking, neutralization and intellectual Obsession had more scores(P0.05).

The results obtained, in terms of more attention to obsessive-compulsive disorder is important in reducing migraine attacks.