فهرست مطالب

Shiraz Emedical Journal
Volume:21 Issue: 10, Oct 2020

  • تاریخ انتشار: 1399/07/21
  • تعداد عناوین: 8
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  • Ali Moradi, Seyed Saeed Hashemi Nazari, Farnaz Zandvakili, Pegah Ameri, Ali Nikfarjam, Sonia Darvishi, Mehdi Noroozi, Khaled Rahmani * Page 1
    Background

    Human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) is a major public health problem in Iran. It imposes heavy costs on governments and affected people. Determining the survival duration of patients and recognizing the related factors can help the disease surveillance system.

    Objectives

    The current study aimed at determining the survival rate and the related factors concerning patients with HIV/AIDS identified in Tehran, Iran.

    Methods

    The study population of the current retrospective cohort consisted of patients with HIV/AIDS covered by the Health Center of Southern Tehran. The data were obtained by referring to the HIV/AIDS care centers and reviewing the patients’ records. Survival rates of the study subjects during 10 years follow-up were calculated. The Cox proportional-hazards model was used to determine the relationship between independent variables and survival of patients with HIV/AIDS.

    Results

    A total of 487 patients were investigated in the current study. Four-hundred thirty-three subjects (88.9%) were male, and 54 (11.1%) female. The mean ± standard deviation of the participants’ age was 44.08 ± 9.00 years. According to univariate analyses, the variables of gender, marital status, education level, occupational status, transmission way, infection with hepatitis C or tuberculosis, and history of antiretroviral treatment were significantly associated with the survival time of patients with AIDS. In the final model, a significant relationship was found between the variables of treatment, coinfection with tuberculosis, occupational status, education level, marital status, and mortality.

    Conclusions

    The current study was one of the few research that examined the survival rate of HIV-infected patients in Iran. Considering the expansion of AIDS epidemic in Iran, it is necessary to take appropriate measures to prevent the spread of the epidemic and decrease the mortality rate of infected patients through early detection and timely treatment of HIV-positive people coinfected with tuberculosis, creation of employment opportunities for patients and addicted individuals, controlling substance abuse, and paying more attention to harm reduction programs in individuals that have unsafe sex as one of the most important high-risk groups to increase their survival time.

    Keywords: Risk Factor, HIV AIDS, Survival
  • Movahed Shahrokhi, Mitra Amini *, Farnaz Takmil, Najaf Zare, Parisa Nabeiei, Farhad Lotfi Page 2
    Background

     As one of the most important components of curriculums, the educational environment provides learners with a forum in which they can learn communication skills and other abilities such as critical thinking and clinical problem-solving. To improve this environment and consequently upgrade medical education, the current environment must be evaluated.

    Objectives

     In a quest to adapt a valid and reliable instrument for this purpose, this study aimed to assess the reliability and validity of the Persian translation of Dutch Residency Educational Climate test (D-RECT) to measure the quality of the educational environment in the main clinical wards of Shiraz University of Medical Sciences.

    Methods

     In a cross-sectional study, a forward Persian translation of the D-RECT questionnaire was translated and back-translated by two bilingual expert panels, and its reliability was determined in a pilot study. Then, 100 residents working at internal medicine, surgery, pediatrics, and gynecology wards were selected randomly to fill out the questionnaire. Data were analyzed using SPSS version 21 software.

    Results

     The Persian translation of D-RECT had acceptable validity, reliability, internal consistency, and reproducibility. The reliability of the questionnaire was confirmed by Cronbach’s α of 0.95. Convergent validity was 0.61 to 0.90. Among the wards evaluated in this study, the educational environment was significantly better in the pediatric ward than in the other wards.

    Conclusions

     The Persian translation of D-RECT validated in the studied departments seems to be an effective, valid, and reliable instrument for evaluating and comparing the quality of the current educational environment for residents in Iran. This evaluation can help improve training.

    Keywords: Residency, Internship, Educational Measurement
  • Leila Khojastepour, Mohammad Ghasemi, Shabnam Rasti, Mahvash Hasani * Page 3
    Background

     Injuries to the lingual and inferior alveolar nerves (IAN) through third molar surgery are common and complicated clinical problems. Juxta-apical radiolucency (JAR) is one of the new radiographic signs, suggestive of IAN damage.

    Objectives

     This study aimed to assess the relationship between JAR and IAN and to determine its effects on the cortical plate.

    Methods

     In this cross-sectional study, after evaluating an initial sample of 450 cases, the cone-beam computed tomography (CBCT) images of 20 patients with JAR were compared with those of 20 age-matched patients without JAR in the axial and multi-planar images. The relationship between JAR and IAN was evaluated, and thinning of the mandibular cortical plates was also investigated. Statistical analysis was performed using descriptive tests and chi-square test in SPSS version 23.

    Results

     The relationship between JAR and IAN was statistically significant (P = 0.001). The cortical plates were perforated in 75% of cases with JAR as opposed to 45% of cases without JAR (P = 0.06). The relationship between the location of JAR and IAN was also significant (P = 0.004).

    Conclusions

     Based on the present results, JAR was associated with IAN in most cases. Thinning of the cortical plates was observed in all cases of JAR.
     

    Keywords: CBCT, Juxta-Apical Radiolucency, IAN Injury
  • Mahtab Peivastegan, Mehdi Rajabi, Hamid Zaferani Arani, Maedeh Olya, HesamAdin Atashi, Shahla Abolghasemi, * Page 4
    Background

     Osteoarthritis (OA) is one of the most common chronic rheumatoid diseases, which affects the cartilage and tissue surrounding the joints. OA causes pain and disability among the old population in most of the developing and developed countries. This disease does not have a definitive treatment, and a conventional treatment only controls the symptoms and pain. Pistacia atlantica cream can inhibit many of the enzymes involved in the inflammation process of OA.

    Objectives

     The current study aimed at evaluating the effect of the topical cream of P. atlantica oleoresin on pain relief in patients with knee OA.

    Methods

     P. atlantica cream formulated in the current study was used to reduce the pain, inflammation, and problems of patients with knee OA; it also descended the serious side effects of conventional therapies. The present clinical trial was conducted on 84 patients with knee OA (grade 2 or 3) parallelly for three-month periods, and diclofenac gel was used as a control drug in the same dosage and period. The formulation was analyzed for standardization with the gas chromatography–mass spectrometry apparatus. The Western Ontario and McMaster universities OA index questionnaire was used to assess the treatment trends.

    Results

     The improvement trend was observed in both groups, while patients who received P. atlantica cream had a significantly higher rate of symptoms improvement than those receiving diclofenac gel (P < 0.05).

    Conclusions

     P. atlantica cream significantly reduced pain and stiffness of joints in patients while performing daily living activities. High analgesic effect of α-pinene and the anti-inflammatory effect of P. alantica were the main reasons for the high inflammatory effect of P. atlantica. Finally, the topical use of P. atlantica cream formulated in the current study, along with other common drugs, can be suggested.

    Keywords: Knee, Osteoarthritis, Diclofenac, Pistacia atlantica, The Western Ontario, McMaster Universities Osteoarthritis Index (WOMAC)
  • Masoud Karimi *, MohammadHossein Kaveh, MohammadAli Morowatisharifabad Page 5
    Background

    Smoking is one of the greatest challenges for public health. It is estimated that 7% - 25% of adolescents have experienced smoking in Iran.

    Objectives

    The present study aimed to investigate the viewpoints of high school male students, their parents, and teachers about smoking by adolescents based on four components of the social marketing mix.

    Methods

    A qualitative study with a phenomenological approach was conducted via 12 focus group sessions in Persian language. To this end, 82 participants (30 students, 28 parents, and 24 teachers) were selected based on purposive sampling method in 2015.The data were analyzed through directed content analysis.

    Results

    All the three studied groups viewed “looking older” as the major cause of adolescent smoking, other factors included getting others’ attention, looking smart person, calmness, decreasing pain, and attractive packaging of cigarette. Some differences were observed between the viewpoints of students, parents, and teachers about the complications of cigarette. The students focused on the social consequences of smoking, but the parents and teachers were more worried about its long term physical side effects and addictive properties. Unlike parents, the teachers and students considered imitating from parents and famous people as the main socio-environmental factor of smoking. All three groups believed that people’s negative social image and negative attention towards smokers should be included in smoking prevention educational programs. However, some differences were reported between their ideas in other educational subjects.

    Conclusions

    Evaluating factors related to tobacco use from three different perspectives can provide a more comprehensive view of these factors and show the reason for the failure of many efforts to prevent student tobacco use and develop a more effective program to promote health.

    Keywords: Adolescent, Smoking, Qualitative, Social Marketing, Focus Group
  • Mahmood Sovid *, Maryam Bahmani, Alamtaj Aamsami Page 6
    Background

     Iodine need is increased during pregnancy and its deficiency can lead to complications in mother and fetus. The latest international guidelines have recommended a higher intake of iodine. Iran has implemented a national salt iodization program since 25 years ago, and the general population is iodine-sufficient. However, recent studies have shown that a significant proportion of pregnant women have urinary iodine concentration (UIC) below the recommended range of 150 - 250 µg/L. Based on the results of these studies, iodine supplement during pregnancy is widely used, but this practice is controversial.

    Objectives

     The aim of this study was to evaluate the necessity for iodine supplementation in pregnant women living in Shiraz, an iodine-replete area.

    Methods

     In this cross-sectional case-control study, UIC and thyroid-stimulating hormone of 174 pregnant women taking 150 µg/day iodine (group 1) were compared with 124 pregnant women not taking the supplement (group 2). The proportion of women with UIC below the recommended level in each group was also determined. UIC of the women in different trimesters in each group was also investigated and compared.

    Results

     Mean UIC in groups 1 and 2 was 175.71 ± 56.43 µg/L and 122.5 ± 44.37 µg/L and this difference was significant (P = 0.006). Also, 56% of women in group 2 and 24 % in group 1 had UIC below the recommended value (P < 0.01). Mean UIC in both groups decreased with advancing gestational age. In group 1, mean UIC remained in the recommended range, whereas in group 2, it decreased to less than 100 µg/L.

    Conclusions

     In areas covered by the national salt iodine implementation program, it is necessary to recommend iodine supplement to pregnant women to prevent iodine insufficiency.
     

    Keywords: Pregnancy, Iran, Supplement, Iodine
  • Naval Heydari, Roksana Janghorban, Marzieh Akbarzadeh* Page 7

    Religious attitude is one of the factors affecting mental health; thus, considering motivation as a psychological factor, this study aimed to investigate the relationship between religious attitudes and academic motivation of nursing and midwifery students. This descriptive-analytical study was conducted on 139 nursing and midwifery students of Shiraz University of Medical Sciences who were selected randomly in 2016. The questionnaire consisted of 3 parts of demographic data, religious attitude questionnaire of religion attitude scale-review (RAS-R), and academic motivation adopted from the questionnaire developed by Hermens. The mean score of the students’ academic achievement motivation was 83.56 ± 8.29, and that of religious attitude was 97.2 ± 15.5. The relationship between the total score of the student's academic motivation and religious attitudes based on the Pearson correlation coefficient test was significant, with P < 0.001 at a significance level of 0.01. Based on the linear regression test, also the relationship between the two variables at a significance level of ≤ 0.05 was significant with P < 0.001, r = 0.412, and r2 = 0.164. So, a positive relationship was observed between religious attitudes and academic achievement motivation in students.

    Keywords: Attitude, Student, Religious, Motivation, Academic
  • Hossein Golriz, Shirin Haghighat, Vahid Reza Ostovan, Nasrin Shayanfar, Mansour Parvaresh, Haniyeh Javanmardi, Anahid Safari, Afshin Borhani Haghighi * Page 8