فهرست مطالب

Shiraz Emedical Journal - Volume:20 Issue: 3, 2019
  • Volume:20 Issue: 3, 2019
  • تاریخ انتشار: 1397/12/18
  • تعداد عناوین: 8
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  • Mohammad Rastegarian , Zahra Ghanbarinasab , Roham Borazjani , Mahnaz Hosseini , Shiva Aminnia , Soheil Ashkani, Esfahani*, Qasem Asgari , Bahador Sarkari Page 1
    Background
    Cutaneous leishmaniasis (CL), caused by the intracellular protozoa Leishmania, causes full-thickness skin wounds and scar formation afterwards, which may bring about some complications such as scar formation, secondary infection, and wound expansion.
    Objectives
    This investigation was conducted to determine the effect of hydroalcoholic extract of silymarin, as an anti-oxidant, anti-inflammatory, and anti-scar, for treatment of CL caused by Leishmania major.
    Methods
    A total of 28 female BALB/C mice were injected with amastigotes of Leishmania major and after the wounds came up on their tail-base they were randomly divided into four groups (n = 7): E1 and E2, which received silymarin 5% and 10% gel, respectively, and C1 and C2 were treated with normal saline and vehicle gel, respectively, every 24 hours for 20 days. Wound size was measured every three days. Finally, the mice were sacrificed with high dose of ether, and full-thickness skin samples from the wound site was obtained for stereological estimation of collagen and vessel volume densities, fibroblasts population, vascular length density, and mean diameter of the vessels.
    Results
    Silymarin gel in either concentration of 5% and 10% accelerates wound closure (P < 0.05) and also improves collagen synthesis and revascularization by means of increasing length density, volume density, and mean diameter of blood vessels (P < 0.05).
    Conclusions
    Topical administration of silymarin extract in both doses of 5% and 10% showed promising effects on the healing process of CL-induced wounds.
    Keywords: Silymarin, Leishmaniasis, Cutaneous Leishmaniasis, Wound, Stereology
  • Behrooz Hamzeh , Zeinab Moradinazar , Mehdi Moradinazar , Farid Najafi *, Shahab Rezaeian Page 2
    Objectives
    The aim of this study is to determine the epidemiology of substance use in terms of age of initiation, duration of use and age of patients when they seek the treatment.
    Methods
    This cross-sectional study was performed on drug-dependent individuals (4176 subjects), who had referred to methadone maintenance treatment (MMT) centers of Kermanshah province, western Iran, during year 2015. The information was gathered by psychologists working in substance use wards, who interviewed clients seeking treatment.
    Results
    Mean age of substance use initiation was 24.1 ± 8.2 year. On average, males and females became dependent on illegal drugs only after 3.6 and 2.5 year since substance use initiation, respectively. The chance of treatment failure for persons over 55 years was 2.5 (95%CI: 1.6 - 3.8) times higher than that for patients aged less than 24 years old. Generally, chance of treatment failure increased by 1.2 (1.1 to 1.3) for every one-year increase since substance use initiation.
    Conclusions
    Given that the age of substance use initiation is very low in Kermanshah and it has a declining trend in Iran, and has a declining trend, increase/decrease in prevalence/age of using illegal drugs is expected unless efforts are made to change status and implement preventive programs.
    Keywords: Substance Use Initiation, Abuse, Substance-Related Disorders, Addiction
  • Mahmood Nekoei, Moghadam , Javad Nazari , Mohammad Reza Amiresmaili , Saeed Amini * Page 3
    Background and Objectives
    In Iran, the private dental sector is the main provider of dental services, however, the price of services that are charged by them is unclear. This study aimed at evaluating the factors affecting fee-setting for dental services delivered by dentists in the private sector and the relative value of services.
    Methods
    In this cross-sectional study, the census sampling method was used among dentists working in the private sector of Kerman city, Iran. The data were collected through a researcher-made questionnaire, the validity and reliability of which were established. Descriptive statistics and Pearson’s correlation coefficient were used to analyze the data.
    Results
    Of the 252 qualified dentists, 147 (58%) participated in this study, of whom 61.5% stated they had reduced their prices to attract more patients and 67.4% mentioned that there is a competition between dentists in attracting more patients. The tariffs applied by the dentists were within the range of government approved tariffs. After the dentist’s wage (42.3%), the most important factors that affected tariff setting included office rent (18.6%), raw materials (15.2%) and staff’s salary (12.6%). Disease severity, dentistry error, dentist’s skill and visit time length should be considered in determining the relative value of services and setting a justified and fair tariff.
    Conclusions
    It is necessary to take appropriate measures by dental health authorities to increase the competition between private dentists in order to decrease prices in favor of patients. Also, due to differences in performance, experience and materials used by dentists and other factors, it is necessary to set maximum and minimum values for tariffs.
    Keywords: Dentists, Private Sector, Fees
  • Azita Mokhtari , Masoud Mohammadi , Parvin Afsar, Kazerooni , Hadi Kajbaf Nejad , Mohsen Ali Akbarpoor , Nasrin Motazedian * Page 4
    Background
    Prevalence of risky behaviors among various classes of society, especially adolescents and youths, is a major social problem, which inevitably slows down the societal progress.
    Objectives
    We aimed to investigate the mediating role of differentiation of self between parental bonding and risky behavior among adolescents and youths in Shiraz.
    Methods
    This study included 560 adolescents and youths (aged from 15 to 35 years, average = 25.7, SD = 7.1; 67.7% males) with risky behaviors who were attending drop in center and Voluntary Counselling and Testing centers, those incarcerated, and those kept in the correctional and rehabilitation facilities 2013 - 2014. Questionnaires about parental bonding, self-differentiation, and risky behaviors were completed by the participants on a voluntary and confidential basis.
    Results
    No significant correlation was found between parental bonding and risky behaviors in the adolescents and youths (t = 1.87). There was also no significant correlation between parental bonding and DS (t = 0.68). Moreover, there was no significant correlation between the differentiation of self and risky behaviors (t = 0.77).
    Conclusions
    Differentiation of self hadn’t a mediating role between parental bonding and risky behaviors among the adolescents and youths in our study.
    Keywords: Adolescent, Health Risk Behaviors, Parents, Role
  • Naser Hoboubi , Nasrin Asadi *, Fatemeh Kamari Ghanavati , Omid Jabery Page 5
    Background
    This study investigated the workload and its effects on the prevalence of needlestick injuries (NSIs) among the nurses in the hospitals affiliated with Ahvaz University of Medical Sciences (AUMS).
    Methods
    In this cross-sectional study, 416 registered nurses working in different wards of the hospitals affiliated with Ahvaz University of Medical Sciences (AUMS) were randomly selected. Data collection instruments were a demographic questionnaire and NASA-TLX workload questionnaire.
    Results
    The prevalence of NSIs in the total work experience and the last year were 72% and 50%, respectively. The mean total score of NASA-TLX calculated to the extent of 78.27 ± 12.2. The regression modeling demonstrated that NSIs significantly correlated with patients treated/d (OR: 1.136, CI: 1.02 - 1.27, P value: 0.002), Timing of injury (OR: 2.13, CI: 1.20 - 3.79, P value: 0.010), and the third dimensions of NASA-TLX index (time pressure) (OR: 1.031, CI: 1.02- 1.05, P value: < 0.001).
    Conclusions
    The study showed a high prevalence of NSIs among nurses. Corrective measures such as planning training programs targeting at using personal protective equipment (PPE), modification of work schedule by limiting working hours and the number of shifts per month, and providing sufficient human resources are essential for the effective prevention of NSI incidents among the studied nurses.
    Keywords: Needlestick, Nurses, Workload
  • Mohtaram Houshmandpour , Zohreh Mahmoodi *, Razieh Lotfi , Maryam Tehranizadeh , Kourosh Kabir Page 6
    Background
    Pregnancy is one of the most important and sensitive stages in a woman’s life.
    Objectives
    The present study was conducted to investigate the effect of midwife-oriented group counseling, based on Orem’s model on self-care and empowerment, in primiparous women presenting to select health centers.
    Methods
    The present parallel randomized controlled trial was conducted on 74 pregnant women presenting to select health centers in Talesh, Iran, in 2017. The eligible candidates were selected using convenience sampling and were then divided into an intervention (37) as well as a control group (37) in randomized blocks of four. The participants completed the pregnancy-related empowerment and pregnant women’s self-care questionnaires before, immediately after, and three weeks after the intervention. Data were analyzed by using SPSS-24.
    Results
    The results showed that the intervention increased the mean total score of empowerment before, immediately after, and three weeks after the intervention in both groups, however, the effect was more sustained in the intervention compared to the control group (P < 0.001). The results also showed that the intervention increased the mean total score of self-care before, immediately after, and three weeks after the intervention in both groups, however the effect was more sustained in the intervention compared to the control group (P < 0.001).
    Conclusions
    Midwife-oriented group counseling affected pregnant women’s empowerment and self-care. Furthermore, the importance of maternal health and midwives’ role as health counselors suggests the need for a greater attention to this issue.
    Keywords: Group Counseling, Empowerment, Self-Care, Pregnant Women, Orem’s Model
  • Negar Sadeghi , Habibeh Ahmadipour * Page 7
    Background
    Poor adherence to antihypertensive treatment has been a global challenge. It is necessary for health care providers to identify the factors affecting treatment adherence.
    Objectives
    The present study aimed to investigate the adherence to treatment and its related factors in patients with hypertension.
    Methods
    A cross sectional study carried out from September 2017 to March 2018 on 600 patients with hypertension who were covered by urban community health centers in Kerman, Iran. The Persian version of Morisky medication adherence scale (P-MMAS-8) and hypertensive treatment adherence scale (HTAS) were used for assessing adherence to the medication and treatment, respectively. Data was analyzed by SPSS software version 19.0 using Independent t-test, ANOVA and logistic regression.
    Results
    The mean age of participants was 56.44 ± 12.3 years, with the majority of them (70.0%) being female. Poor adherence to medication and treatment was found in 304 (50.7%) and in 238 (39.7%) patients, respectively. Age, level of education, and the presence of concurrent medical disease and psychological disorder significantly predicted the adherence to treatment.
    Conclusions
    Poor adherence was common among hypertensive patients in our primary health care setting. Therefore, it is necessary for our health care providers to identify the factors associated with poor adherence to be intervened timely.
    Keywords: Hypertension, Medication Adherence, Treatment Adherence, Chronic Diseases, Iran
  • Najmeh Maharlouei , Sina Atefi , Kamran Lankarani * Page 8
    Considering that the birth cohort study is the most appropriate model for studying and evaluating the relationship between exposures during the initial evolution and its long-term effects on the development of diseases, this prospective cohort study is designed for this purpose. Through a stratified random sampling, 6921 women, who were in the 20th to 30th week of gestation and lived in Fars province for at least six months prior to the interview, participated in this prospective cohort study. The study started in 2011 and the 4th follow up was finished in 2017. During the enrolment phase and four follow up after birth, the following information was collected in detail: socioeconomic status, knowledge and attitude of mother, husband toward normal vaginal delivery (NVD) and cesarean section (SC), early and late complications of delivery in mothers and babies, breastfeeding, any medical history in mothers and children, physical activity in children, and common psychiatric problems in mothers. So far, several articles have been published on the first results of the study. Mothers and children under the study will have three more follow ups until the children are 12 years old.
    Keywords: Cohort, Birth, Fars, Iran