مجله دانشگاه علوم پزشکی گیلان
پیاپی 111 (پاییز 1398)

Diabetesis one of the most common chronic conditions and a major public health concern in Iran. Increasing awareness regarding diabetes can reduce mortality and economic burden on health systems.

To determine the level of diabetes related health knowledge, attitude and practice (KAP) among diabetic patients residing in west of Mazandaran Province.

This descriptive cross-sectional study was carried out on the patients with type-2 diabetes, referredto Ramsar 13Aban Pharmacy and Shafa outpatient clinic from May 2016 to Feb 2017. 240 patients were enrolled in the study and a questionnaire was filled through face-to-face interview. Level of KAP was evaluated by calculating the scores and the data were analyzed by SPSS software.

The mean age of patients was 58.27 (159 females and 81 males). The level of patients’ Knowledge, attitude and performance about diabetes were 59.36%, 38.5% and 51.35%, respectively. There was a positive significant relationship between patients’ level of knowledge and their educational level. The attitude score was lower in patients without family history. Moreover, better performance level was observed in females and in patients treated with insulin plus oral antidiabetic agents.

Results of the present study indicat ethe low level of KAP among diabetic patients about self-care and proper education of diabetic patients by regular programs can lead to better control, prevention of disease progress and decrease in health system costs.
Conflict of interest: non declared

Nanosilver is a nanotechnology product with antimicrobial property. It can improve efficiency, reduce cost and increase antimicrobial durability and performance of wound dressing.

This research intended to introduce a dressing that accelerated and improved the wound healing process by keeping the wound area moist and simultaneously prevented colonization by microorganisms and wound infection.

Silver nanoparticles were trapped in the pores of calcium alginate sheets, and particle loading on films took place. When this dressing is put on a wound, the silver ions are released in the wound area. After loading the silver nanoparticles; their presence in the calcium alginate structure was confirmed by FE-SEM micrographs. Wounds (2 × 2 cm2) were made on rats’ bodies and images were taken of the wound healing process on the 1st, 7th, and 14th days to study the effect of the dressing on tissues of living organisms.

Characterization of silver nanoparticles was carried out by the DLS test and Zeta potential measurement, in which the values of 61.4 nm and -20.83 mV were obtained, respectively. Antibacterial properties were studied and cell toxicity tests were performed to determine the suitable concentration. Results indicate that the optimum concentration was 100μg/l (or 17.5μg per unit area of the alginate film). Using the ImageJ software, the surface areas of the wounds were calculated, and histological studies were also conducted on wound healing. Moreover, on the 7th and 14th days, samples were taken of them to carry out histopathological investigations, and changes in skin cell shape were studied.

The results of this study suggestthat the dressing accelerates simultaneously the process of wound healing and prevents wound infection and postponement of its repair.
Conflict of interest: non declared

psychiatric disorders in children and adolescents are very important.To understand more of etiology, diagnosis and treatment as well as prevention, the first step is epidemiological studies.

To evaluate the prevalence of psychiatric disorders in children and adolescents aged 6 to 18 years in Rasht city and suburbs and the relation between the presence of a mental disorder and demographic characteristics of the children and the families.

This study is a cross-sectional analytical study conducted in Rasht city and suburbs.The statistical population includes 147653 children and adolescents aged 6 to 18 years in Rasht and suburbs.We selected 1024 children and adolescents aged 6-18 years by multistage cluster random sampling method from urban and rural parts of Rasht. The clinical psychologists completed the Persian version of Kiddie-SADS-Present and Lifetime Version (K-SADS-PL). Data were analyzed by SPSS version 16 and were interpreted using descriptive statistics (mean, standard deviation) and odds ratios.

The overall prevalence of psychiatric disorders in children and adolescents aged 6 to 18 years in Guilan province was 20/7% (95% confidence interval 18.33-23.29%). The most common disorder was any Anxiety disorder (14.1%). Based on the results,Separation anxiety disorder (6.6%), Generalized Anxiety (5/9%), Phobia (3/4%) and Agoraphobia (3/2%) were the most prevalent disorders in this population.

The high prevalence of anxiety disorders demands further consideration and treatment plans on the part of corresponding authorities.
Conflict of interest: non declared

Today, hospitals are faced with severe constraints on financial resources and a large amount of hospital fees are not reimbursed annually by health insurances leading to irreparable financial damages to hospitals. So knowledge of the reasons responsible for such conditions is essential. The purpose of this study was to determine the rate and causes of deductions for social insurance and health insurance applications in a rasht educational hospital.

Exploring the rate and causes of the deduction by health insurance and social security insurance in an educational hospital in rasht.

This study was a cross section one conducted on one of the educational hospitals affiliated with Guilan University of Medical Sciences. Social insurance deductions reported for 2017 were organized by referring to the unit of income with differentiating the type of fraction by determining the minimum and maximum deductions and its relationship with different months of the year as comparative tables The resulting data were analyzed through descriptive statistical methods, using the SPSS software, version 16.

The most deductible applied to social insurance policies with a total of 19,030,679,568 Rials were related to counseling, visit and surgeon, with a total of 38,597,297,828 Rials being related to counseling, visit and pathology in health insurance.

The highest deductions were due to the lack of documentation by personel due to lake of knowledge. Therefore, in order to reduce deductions, the use of a multilateral mechanism, including the formulation of policies on the use of clinical guidelines, the training of doctors and contracting with the doctors who have the most cooperation in this field are recommended.At the same time, continuous explanation and implementation of these activities in the hospital organizing a committee is necessary.
Conflict of interest: non declared

Considering the different treatment methods and their controversial efficacy and the importance of proper treatment with decreasing complications and costs for patients with acute Ileofemoral DVT, this study aimed to assess the success rate and complications of catheter-directed thrombolysis in patients with acute Ileofarmal DVT, referred to Razi Hospital in Rasht, 2017-2018.

To evaluate the Success Rate and Complication after Catheter Directed Thrombolysis in Acute Deep Vein Thrombosis of Ileofemoral Vein

This case-series study was performed onthe  patients with acute Iliofemoral DVT underwent catheter-directed thrombolysis referred to Razi Hospital in Rasht, 2017-2018. All patients diagnosed with acute Iliofemoral DVT on the basis of color Doppler ultrasonography and venography were candidates for treatment. Patients with concomitant illnesses, such as diabetes mellitus, hypertension, underlying conditions such as malignancy and any other illnesses other than DVT, were excluded. The variables studied in this study were collected using a questionnaire.

In this study, 20 patients with acute Iliofemoral DVT younger than 60-year-old with the onset of symptomless than 2 weeks were studied. The mean age of the subjects was 39.15±12.07 years, 11 (55%) cases were male and the rest were female. 13 cases were affected by acute left Iliofemoral DVT. AS for initial symptoms, the highest frequency (65%) was related to pain, swelling, and tenderness. The results of the study showed that there was a 100% success rate, and none of the patients in the follow-up period of 6 months showed restenosis.

Based on this study and comparison to other authors’ recommendations, it seems that the success ratein catheter-directed thrombolysis in patients with acute Ileofemoral DVT was100%. There were no complications in 75% of the patients. The most reported complication was pain and there was no statistically significant relationship between the complications of the patients during the treatment, the duration of admission and age and sex.
Conflict of interest: non declared

Substance Abuse Subjects after drinking and entering Rehabilitation Therapies, reuse drugs in a short period of time.

Determination of factors associated with drug abuse recurrence in Drug AbuseTreatment Centers Patients.

This is a cross-sectional study with control group selection. The population under study consisted of those referred to the Drug Abuse Treatment Centers in Shafa Hospital of Rasht in 2016-2017. 82 subjects (41 cases and 41 controls) were selected by available sampling method and completed researcher-made questionnaires containing demographic data and factors related to the recurrence of drug abuse from one's point of view, as well as GHQ 28. Data were analyzed using SPSS-22 software.

There was a significant relationship between consumption recurrence with job type (p = 0.031), low income (p = 0.036), opium type (p = 0.020), cannabis (p <0.0001) and glass (P = 0.008).  The odds of relapse were significantly lower amongst consumers in the food way (p = 0.026). There was a significant relationship between total score of mental health and relapse of substance abuse and a unit of mental health score reduction increased the odds of recurrence of drug abuse by 1.15 times. Among the components of mental health, social dimension has a significant relationship with the recurrence of substance use

The results showed that multiple economic, individual, familial, social and psychological factor sare predictive of the recurrence of drug abuse.
Conflict of interest: non declared

Multiple risk factors are associated with depression during pregnancy, but so far the effect of fetal sex on depression in pregnancy has not been investigated in Iran.

Frequency survey and depression – related factors with emphasis on relationship between depression and fetal sex in pregnant women referred to Al-Zahra Rasht.

This analytical cross-sectional study was done within a period of two months (June and July 2013) on 500 pregnant women referred (more than 20 weeks of pregnancy) to prenatal care of Al-Zahra hospital. The questionnaire consistingof two demographic data and midwifery sections and Beck standard depression inventory were completed by patients who had the inclusion criteria.

The prevalence of depression in 500 pregnant women was found to be 27.4%. Factors associated with depression in pregnancy using multiple Logistic regression models, maternal employment status, number of children, same sex of fetus with previous children, duration of notice from fetus sex, family history of depression, stressful event and satisfaction from spouse, and were identified as the most powerful variables affecting theincidence of depression in pregnancy. There was no significant relationship between depression and fetal gender.

The high prevalence of depression among pregnant women in this study, compared with global studies suggests the need for more reviews and principal interventionalstudies in this field. The same gender of fetus with previous child and duration of knowledge of fetal sex had a significant relationship with depression during pregnancy. According to the results of this study, screening of the groups at risk of depression is recommended.
Conflict of interest: non declared