مجله دانشگاه علوم پزشکی گیلان
پیاپی 114 (تابستان 1399)

Exclusive breastfeeding protects infants from diseases in the first 6-months of life. Awareness and attitude affect breastfeeding performance.This study assessed maternal awareness and attitude toward breastfeeding in Alzahra Hospital, a baby friendly, in Rasht, Iran.

To determine knowledge and attitudes of mothers on various aspects of breastfeeding and factors related to them among mothers under postpartum, Alzahra educational, medical and research center.

This descriptive cross-sectional study was conducted on 384 post-natal mothers. It was done by sampling and simple random in post-partom unit of Alzahra Hospital, Rasht. A questionnaire consisting of 3 main parts; demographic information, knowledge and attitude, was used in the study. Attitude and knowledge scores were also calculated. Data were analyzed by Man-Whitney, Kurskal-Wallis and Spearman Correlation Coefficient tests, using SPSS-software in version21.

In this study, 32.6% had good levels of knowledge about breastfeeding and majority of them (39.1%) had an average knowledge. All of mothers had positive attitude, but 20.3% of mothers had more positive attitude and most of individuals (67.2%) were in the intermediate state and the rest had a more negative attitude. In the multivariate analysis in the regression logestic model attitude status (P<0.0001), experience of breastfeeding(P=0.006), breastfeeding training (P=0.004), income (P=0.03) and mother’s job (P=0.001) were anticipating factors of high knowledge, and the status of knowledge(P=0.043), mothers’education(P=0.004), natural delivery compared to cesarean section  (P=0.008), type of infant’s feeding (P=0.0001) were anticipating factors related to positive attitude status. Also, a significant poor positive relationship was found between age and the score of knowledge (r=0.158, P=0.002) and attitude (r=0.128, P=0.062).

A significant number of mothers had moderate knowledge about breastfeeding, which necessitates intervention programming, especially for mothers with low levels of education.

The extent of development of a country is determined by research indicators such as the number of published articles. Many factors can cause a lack of research.

The present study aimed at identifying obstacles to the implementation of the research from the viewpoint of faculty members of Guilan University of Medical Sciences in 2018.

In this combined research, the quantitative data were collected by the faculty members of the research pathology questionnaire. The appropriate statistical indices were used to describe the data. In the qualitative section, sampling was purposeful and continued until data saturation. Data were collected through semi-structured interviews and data analysis was carried out using a seven-step content analysis approach. The accuracy and accuracy of the data were also determined by Lincoln & Gubachr('39')s proposed criteria.

In the quantitative part, the most important inhibitor factors include management factors (low communication between university and foreign universities), empowerment factors (lack of familiarity with relevant statistical techniques), administrative rules (length of paper publishing stages), and personal factors (teaching too much), social factors (inadequate intellectual incentives) and economic factors (inadequate research budget and lack of research facilities). In the qualitative section, the four main categories (individual challenges, dysfunctional infrastructure, Limited Research Partner, and discouragement of the research result) and fifteen sub-floors were extracted.

According to the results of this study, in order to improve the quantitative and qualitative research among faculty members, it is suggested that the respective authorities consider such issues as strengthening the research motivation of faculty members taking advantage of research facilities and special privileges, and also equivalence of research tasks.

Acanthamoeba, also called  amphizoic amoebae, could live in various environmental sources including water, soil, dust and also human and animal tissues. This amoeba could develop diseases such as keratitis and encephalitis in high-risk individuals.

The present study was conducted considering the possible contamination of hospital wards with Acanthamoba and the lack of knowledge regarding their loads in the dust of hospital wards of Guilan province.

In Guilan 2018, a total of 108 dust samples from wards including ophthalmology, ENT, hematology and chemotherapy were collected from internal environment of educational hospitals and examined for the presence of Acanthamoeba spp. by morphologic features of both trophozoites and cyst stages. Termotolerant assay was conducted in order to determine the presence of potentially pathogenic Acanthamoeba species. The collected samples were then rinsed in sterile water, and the washed solution was filtered using a vacuum pump and 0.45 μm membrane filters. In the end, the filter was cultured on Non-nutrient agar (NNA).

Forty out of 109 samples were positive for Acanthamoeba spp. Temperature tolerance test indicates that 13 out of 40  samples could be potentially pathogenic because they grow at high temperature (42ºC). The frequencies of free-living amoebae in chemotherapy, ophthalmology, ENT and hematology wards were 38.8%, 39% and 29.6% ,respectively.

As revealed, potentially pathogenic Acanthamoeba was detected from dust samples of hospital wards. Presence of the potentially pathogenic and nonpathogenic Acanthamoeba in hospital wards should be a concern for health authorities. Therefore, improvement of sanitation services is recommended for the prevention of infection.

Different studies have investigated the effects of various factors on self-efficacy and clinical decision-making among nurses and other professionals in the fields of health and treatment.  There is, however, little research investigating self-efficacy, clinical decision-making, and the level of relationship between them with regard to the environment and culture of organizations.

This study was conducted with the aim of investigating self-efficacy and clinical decision-making among nurses in terms of individual and social variables and discovering the level of relationship between self-efficacy and ‘clinical decision-making among nurses in Guilan Province in 2017-2018.

This is a descriptive cross-sectional study and 222 nurses working at different units of teaching and treatment centers in the city of Rasht were recruited after obtaining formal written consent from them. The data collection instruments were a demographic questionnaire, a self-efficacy questionnaire and a decision-making questionnaire. To analyze the data, SPSS/ 21 was used.

The results showed no significant difference between nurses’ clinical decision-making scores and the demographic variables of age (p=0.4), education level (p=0.27), Bachelorchr('39')s degree in nursing (p=0.198), work experience (p=0.39) and work shift (p=0.9). There was, however, a significant correlation between self-efficacy score and the age (p=0.001) and work experience at the hospital (p=0.002). The logistic regression analysis indicated that self-efficacy has a significant effect on decision making after controlling for the predictor effects in such a way that by adding one point to the self-efficacy score the score of clinical decision making increased by 0.39 points.

Understanding the relationship between self-efficacy and clinical decision-making of nurses can be indicative of the need for  various training courses to improve the self-efficacy level of nurses so that this working class can create better clinical decisions.

Extracts of Achillea wilhelmsii C. Koch are used as anti-inflammatory, antispasmodic, antihypertensive, and topical anti-dandruff, and skin moisturizer. Given the increasing consumption of this medicinal plant among the people, it is necessary to conduct laboratory research in order to know more about its useful properties and possible harms.

To evaluate the effect of methanolic extract of Achillea wilhelmsii on the liver and kidney functions in rats

Twenty male Wistar rats were randomly divided into 4 groups (each group 5) and were studied for 7 days under the effect of 50, 100 and 150 m/kg herbal extracts. Serum levels of liver and kidney biochemical parameters were then measured. Significant differences between the control and treatment groups were analyzed by t-test at the level of P<0.05, using SPSS 21 software.

Oral administration of A. wilhelmsii extract at doses of 100 and 150 mg/kg significantly increased Alanine aminotransferase (ALT) and Aspartate Aminotransferase (AST), compared to the control group (P<0.05). Also, Alkaline phosphatase (ALP) and Creatinine showed a significant increase only at the dose of 150 mg/kg, compared to that in the control group. But bilirubin in combination with ALP and alanine ALT at 50 mg/kg showed a significant decrease, compared to the control group (P<0.05). Recipients of other doses of extract did not show any significant differences.

According to the findings of this study, oral administration of A. wilhelmsii extract at 50 mg/kg dose significantly reduced liver and kidney enzymes, but at higher doses it did conversely. In order to be more certain about the protective or toxic effects of the plant extract on the liver and kidney, the histopathological effects of different extracts of this plant need to be studied further.

Coronary heart disease is the leading cause of death in industrialized societies. A wide range of clinical symptoms such as angina pectoris, myocardial infarction, and sudden cardiac death are visible in respective patients. The genetic basis and heritability of the disease has recently been identified by examining family lineages in patients. However, understanding the genetic causes of coronary artery disease due to the heterogeneity of clinical symptoms and the pathophysiological processes involved is very complex due to the interplay of genetic and environmental factors. This review article explains the heterogeneity factors involved in coronary artery disease for a better explanation of genetic studies which can lead to a better understanding of the inherited mechanisms of the disease. Such studies could reveal the association of common variants in candidate genes as well as the association of a large number of effective gene loci with the risk of coronary heart disease. Large-scale gene sequencing and applied studies provide a better understanding of the biological risk factors and help better understand the biology of the disease and provide valuable insights into new therapeutic approaches. In addition, such review studies make it possible to conduct genetic tests with a medical approach to identify subgroups of patients at risk for coronary artery disease and use them for prevention and treatment purposes.

A 64-year-old woman with no history of previous illness presented with  a soft tissue swelling of the flexor surfaces of the second finger of the left hand and also palmar surfaces of the same hand without pain and with 2 nodules 1 by 1 cm in that area for about 5 months.  After debridement and excisional biopsy, histopathological examination reported caseous necrotizing granulomatous inflammation.The patient underwent anti-tuberculosis treatment for 6 months.Tuberculosis Tenosynovitis occurs in the palm of the hand. If not diagnosed early, it can lead to functional impairment of the hand by spreading to nearby soft tissues, bone and joint, and may lead to carpal tunnel syndrome. Confirmation of the diagnosis is by excisional biopsy of soft tissue and its nodules and sending for histopathologic examination and acid fast Mycobacterial culture. If the bones and joints are not involved, the anti-tuberculosis treatment will improve it by 6 month treatment. Increased diagnostic awareness and suspicion of this disease leads to timely diagnosis and appropriate treatment and prevents functional disorders.