فهرست مطالب

Shiraz Emedical Journal - Volume:19 Issue: 2, 2018
  • Volume:19 Issue: 2, 2018
  • تاریخ انتشار: 1396/12/09
  • تعداد عناوین: 7
|
  • Hossien Ranjbar, Elham Azmoude * Page 1
    Background
    Sexual function is an important indicator of quality of life, which affects various aspects of women’s health, especially physical health. Although some evidence suggests that people with a greater body mass index experience more sexual dysfunction, this has continually been disputed. A meta-analysis was conducted to evaluate the relationship between these concepts more accurately.
    Methods
    A meta-analysis on all published articles until October 2016 was conducted in Scopus, PubMed / Medline, Springer, Web of Knowledge, Science Direct, and Google scholar databases as well as SID and Magiran (Persian databases) using key words such as “Body Mass Index” AND “sexual dysfunction” AND women. Furthermore, the Random effect model was used for statistical pooling. The heterogeneity of studies was evaluated using I2 index. The data analysis was performed using Comprehensive Meta-Analysis software.
    Results
    9 eligible studies were included into the meta-analysis. The pooled results suggested an inverse association between body mass index (BMI) and sexual dysfunction (Pooled Correlation = -0.222; 95% CI, -0.362 - 0.073). Cochran Q index was obtained as 73.574 (P
    Conclusion
    A weak and inverse relationship was observed between body mass index and sexual dysfunction. It seems the relationship between these variables may be affected by other numerous factors, which requires further investigation to be confirmed.
    Keywords: Body Mass Index, Overweight, Obesity, Sexual Dysfunction
  • Mohammad Mahdi Sagheb, Mitra Amini *, Mahboobeh Saber, Mohsen Moghadami, Parisa Nabiei, Roya Khalili, Rita Rezaee, Leila Bazrafcan, Ali Asghar Hayat Page 2
    Introduction
    Medical students should be trained about the fundamental skills of evidence- based medicine (EBM) during undergraduate medical education curriculum. This article introduces an innovative model for initiation and development of a flipped classroom for teaching EBM to sixth- year undergraduate medical students in Shiraz Medical School, affiliated to Shiraz University of Medical Sciences.
    Methods
    After conducting needs assessment and setting objectives for the program, blended leaning format and flipped classroom strategy were used. A student satisfaction measurement form was designed to evaluate the flipped classroom based on a 5-point Likert scale. The validity of the questionnaire was determined by experts, and the reliability of the questionnaire was 0.86 after a pilot study. We also used the questionnaires based on Berlin questionnaire to measure students’ knowledge, attitude, and practice about the EBM course in a pre- and posttest design. The validity and reliability of the questionnaire had been approved in our previous study. Also, the result of a summative examination after finishing the course was used as a measure of course goal achievement.
    Results
    A total of 280 medical students on their sixth year of study participated in the flipped classroom in 6 different rotations. A total of 266 (95%) students passed the course and only 14 (%5) failed. The results of posttest scores based on the EBM domains revealed that the best result was obtained in teaching clinical questions’ format (patient, intervention, comparison, and outcome). The lowest posttest scores were in the domain of biostatistics. The overall quality of flipped classroom was reported well by the students. The students stated that the ability to apply knowledge and skills in managing patients were developed in this course.
    Discussions
    In our experience, flipping classroom was a practical and essential activity to educate a large number of medical students about EBM. We acknowledge that the development of deep learning is instructors’ responsibility and that implementing blended learning and flipping classroom can facilitate students’ knowledge and skills about this important topic. We hope that other medical schools all over the world use the flipped classroom discussed in this article to redesign their classrooms in such a way that enables students to develop necessary skills and get involved in deep learning. This will improve the health of the society in the near future.
    Keywords: EBM, Flipped Classroom, Blended Learning
  • Zohre Faramarzian, Marzieh Kargar *, Mohsen Dehghani, Najaf Zare Page 3
    Background
    Functional constipation is among the most common problems of childhood. Children’s life quality is affected by constipation. In addition, constipation can bring about undesirable physical and psychic consequences. However, follow-up programs can solve the problem and assure the patient about continuing treatment.
    Objectives
    This study aimed to investigate the impact of nurse-based approaches on functional chronic constipation in children.
    Methods
    This is a clinical trial study conducted from August to December 2013 in Imam Reza clinic. The sample size was 95 children who were randomly assigned to two groups of experimental (47 persons) and control (48 persons). The mean age in the experimental and control groups was 6.25 ± 2.71 and 6.21 ± 2.68 years, respectively. The experimental group received a combination of nurse-centered and education program as well as conventional medical treatment while the control group received only the usual medical treatment. The data were collected using a data collecting form and bowel diary. The recovery percentage was assessed based on Rome 3 criteria in three periods of 1, 2, and 3 months after the intervention compared to before the intervention. The collected data were analyzed by SPSS version 16 software using chi square and Mc Nemar tests.
    Results
    Before the intervention, the similarity of people in the study groups that is necessary for clinical trials was observed. In all variables such as constipation status, sex, weight, duration of constipation, previous therapy, and family history of constipation, there was no statistically significant difference between the two groups (P value > 0.05). The results showed improvements in both the groups. The percentage of improvement assessed by chi square test in the intervention group was 70.2%. This percentage increased to 83% about 2 and 3 months after the intervention; in comparison with the control group, the improvement was higher by 14 and 10%, respectively (P value > 0.05).
    Conclusions
    Nurse-based clinics should be established at gastroenterology clinics to minimize the frustration of parents and children in remission and treatment discontinuation through routine follow-up of long-term treatment (either by phone or in person) that may lead a greater number of patients to achieve remission after treatment.
    Keywords: Children, Functional Chronic Constipation, Nurse, Centered Strategies
  • Mahmood Haghighat, Zahra Amiri, Seyed Mohsen Dehghani, Ali Reza Safarpour, Maryam Ataollahi, Arash Mani, Rahele Haghighat, Abbas Rezaianzadeh* Page 4
    Background
    Constipation is one of the most common Gastrointestinal (GI) symptoms among children. The present study aimed to identify the demographic and clinical characteristics of the children suffering from constipation.
    Methods
    This descriptive-analytical study was conducted on 987 children with constipation in Fars province from March 2015 to March 2016. The study data were collected in the pediatric GI clinic affiliated to Shiraz University of Medical Sciences and analyzed using descriptive statistics, including frequency, mean, and standard deviation (SD).
    Results
    More than 40% of the cases who referred to the pediatric GI clinic were suffering from constipation. Totally, 987 [495 females (50.2%) and 492 males (49.8%)] out of the 1000 children with constipation met the inclusion criteria. The remaining 13 children were excluded due to non-functional constipation. The mean age of the children was 4.8 ± 2.8 years (range: 6.9 months to 17.7 years). In addition, the children’s mean age at the beginning of toilet training and defecation control was 1.9 ± 0.5 years (range: 11 months to 5 years) and 2.1 ± 0.6 years (range: 17 months to 8 years), respectively. The mean of daily physical activity was 2.3 ± 3.6 hours and 707 children (71.6%) had less than one hour of daily physical activity. In addition, 54.2% and 13.9% of the children watched TV and used computer games for more than 3 hours a day, respectively. Finally, 57.5% and 48.3% of the children reported a low consumption of vegetables and grains per week, respectively. Furthermore, having constipation for more than six months was associated with the age of onset of constipation less than two years (P = 0.003). Watching television was reported in 600 (69.7%) children with more than six months constipation (P
    Conclusions
    More than 40% of the cases who referred to the pediatric GI clinic were suffering from constipation. Furthermore, having constipation for more than six months was associated with the age of onset of constipation and watching television habits.
    Keywords: Children, Constipation, Toilet Training, Vegetables
  • Arash Mani, Saeed Ghelijkhani, Raheleh Haghighat, Laaya Ahmadzadeh*, Elnaz Chohedri, Sayyed Taghi Heydari Page 5
    Background
    Evaluation of brain function is achieved through patients’ behavior. One of the self-regulatory behaviors, impaired in various psychiatric and neurological disorders, is executive function. Behavior Rating Inventory of Executive Function-Adult version (BRIEF-A) is a standard tool for the assessment of executive function.
    Objectives
    Thus, the present study aimed at validating the Persian version of BRIEF-A.
    Materials And Methods
    The study population consisted of 318 employees/students of Shiraz University of Medical Sciences and teachers/staff of the Education Department of Juyom, Larestan, Fars province, aged between 18 and 65 years, who obtained a General Health Questionnaire (GHQ-28) score of
    Results
    Cronbach’s alpha for BRIEF-A subscales was as follows: inhibit 0.693, shift 0.774, emotional control 0.838, self-monitor 0.704, and initiate 0.717, working memory 0.775, plan/organize 0.795, task monitor 0.650, and organization of material 0.781. Fitness evaluation of the BRIEF-A model factors showed comparative and non-normed fit index of 0.095, standardized root mean of 0.064, and root mean square error of approximation square residual of 0.051 for 9 areas (75 questions) (P = 0.001), which was also calculated separately for BRI/MI, measuring 0.98, 0.034, and 0.088, respectively (P = 0.001). Test-retest reliability showed a significant correlation between the first and second evaluation (P
    Conclusion
    The present study could successfully validate the Persian version of BRIEF-A with a high validity and reliability.
    Keywords: Executive Function, Behavior Rating Scales, Persian
  • Mohsen Ghasemi, Parsa Yousefichaijan, Masoud Rezagholizamenjany *, Sahar Alizadeh Page 6
    Background
    Parents’ emotional intelligence comprises their prior knowledge, IQ, and technical or professional skills, which can influence chidlren’s emotional dimensions and lead to voiding dysfunction.
    Objectives
    The aim of this study was to investigate the correlation between parents’ emotional intelligence and enuresis in children for a more effective management of this problem.
    Methods
    This case-control study was conducted on 200 children (age range, 5 - 16 years) in Amir Kabir hospital. The case group consisted of 100 children with nocturnal enuresis, and the control group included 100 healthy children. The demographic and emotional intelligence questionares were completed by children and their parents. Also, emotional status was analyzed, based on the global emotional quotient inventory (EQ-i), which was completed by the parents. Finally, the data were compared between the case and control groups.
    Results
    The demographic characteristics were not significantly different between the groups (P > 0.05). All indicators of emotional intelligence were significantly different between the case and control groups (P = 0.001). Different aspects of parents’ emotional intelligence, including problem-solving, happiness, independence, stress tolerance, self-actualization, emotional awareness, realism, interpersonal relationships, optimism, self-respect, continence, flexibility, responsibility, sympathy, and self-expression were significantly different between the groups (P = 0.001).
    Conclusions
    Attention to the parents’ emotional intelligence may be important in the management of enuresis, and we can reduce the duration of nocturnal enuresis by raising the parents’ emotional intelligence.
    Keywords: Emotional Intelligence, Enuresis, Children, Parents
  • Fardad Ejtehadi, Khatere Mirzad Jahromi, Alireza Rahimi, Ladan Aminlari, Maryam Moini * Page 7
    Background
    Irritable bowel syndrome (IBS) is one of the most common functional disorders of gastrointestinal system. The diagnosis of IBS is made by ROME criteria while excluding other organic causes of symptoms. The presence of alarming sings warrants further evaluation by radiologic or endoscopic studies. It is a common belief among gastroenterologists that colonoscopy in the IBS patients (compared to other patients) is more difficult for the colonoscopists and more painful for the patients. The present study aimed at evaluating the difficulty of colonoscopy, intensity of pain sensation, quality of bowel preparation, and other related findings in the IBS patients compared to non-IBS patients.
    Methods
    This study was conducted during January and May 2016 in a single referral academic colonoscopy center in Shiraz University of Medical Sciences on referring adult patients who were classified into 2 groups, IBS and non-IBS. Duration of procedure, quality of colon preparation, severity of pain, and difficulty of the procedure assessed by Visual Analogue Scale (VAS) were the main assessed parameters. Statistical analysis was performed by SPSS software Version No.16, and independent t test was used to compare the means.
    Results
    In this study, 172 patients (59 males and 113 females) were enrolled and allocated into 2 groups, IBS: 72, non-IBS:100. The mean age in IBS and non-IBS groups was 43.4 and 46.6 years, respectively. Although IBS patients had a more statistically significant pain sensation than non-IBS patients during the procedure (5 vs. 4.4 in VAS, P = 0.03), the quality of colon preparation and difficulty of the procedure revealed no significant differences (7.5 vs. 7.2, P = 0.23; and 4.7 vs. 4.8 in VAS, P = 0.6, respectively). The duration of procedure was significantly lower in the IBS group (13.1 vs. 14.1 minutes, P = 0.006), while the success rate for cecal intubation was similar in both groups (97% vs. 95%, P = 0.7).
    Conclusions
    Our results showed that IBS patients had more pain sensation during the colonoscopy, but the procedure itself was not more difficult in this group of patients. Finally, with a similar success rate the duration of colonoscopy was shorter in IBS patients.
    Keywords: Irritable Bowel Syndrome, Colonoscopy, Colon Preparation