مجله دانشگاه علوم پزشکی اردبیل
پیاپی 17 (پاییز 1384)

It is estimated that 4-10% of diabetic patients suffer from foot ulcer. About one in five people with diabetes enters hospital for foot problems. Regarding the importance of education for these patients, the present research was conducted to evaluate the effect of education on foot care among diabetic patients referring to Ardabil Buali hospital. From the diabetic patients referring to Buali hospital (diabetes center) 120 patients admitted for the first time, who had had no past training about diabetes, were selected. Each patient was asked to fill out a questionnaire on his reference to the hospital. The questionnaire had 38 questions, the first 8 of which were about the demographic status and the illness itself and the rest of them concerned priniciples of foot care. Following this, these diabetic patients participated in public classes in the center, and a month later they filled the questionnaire again. Finally their knowledge before and ofter the education period was compared using statistical analyses. The level of knowledge of 73.33% of the subjects before education was medium whereas following the education this rose to 86.67%. Comparing the level of knowledge of patients before and after education using t-test indicated that the level of knowledge after education is significantly higher than before (p<0.001). with regard to the significant difference in knowledge of diabetic patients before and after education, it can be concluded that educational classes of diabetic center can improve the knowledge of patients about foot care. So they are strongly recommended to be held for all these patients.

Considering the high prevalance of congenital obstruction of nasolacrimal ducts in infants and the importance of timely intervention and due to the lack of previous similar researches in Ardebil province, and regarding the discrepancies in the reports about the degree of successful accomplishment of the first probing, the researchers set out to design and perform the present research among the patients referring to ophthalmology ward. This descriptive and cross-sectional study was conducted on 84 children suffering from congenital nasolacrimal duct obstruction who had undergone pobing surgery in Alavi hospitaly between 2000 and 2002. 70 eyes of 50 patients were examined. 27 (54%) were male and 23 (46%) were female. 20 of them (40%) had bilateral involvement and 30 (60%) had unilateral one. Involvement of right eye (60%) was more than left eye (40%) and was expected in first child (56%) more than subsequent offsprings. Clinical manifestation was epiphora in 44%, prulent discharge in 12% and epiphora with prulent discharge in 44%. 90% of the subjects were operated for the first time while 10% had had 2-3 operations before complete recovery was observed in 48% of the patients 46% of them had relative improvement and no recovery was witnessed in 6% of them. This study showed that the male infants were affected more than females, and the rate of involvement in right eye as well as in first children was relarively high. Also the rate of recovery among unilateral groups and infants under 1 year of age was considerably high, so it is recommended that the patients of this age group undertake a therapy with topical antibiotic and lacrimal sac massage and because of the low success of the surgery above 2 years of age, probing is recommended from 6 month to 18 months of age if medical treatment was unsuccessful.

Opium addiction is a major social, psychological and health problem in the world. In past decades addiction to legal and illegal drugs has been widespread and over 1000 kinds of narcotics have been recognized, which are used in different ways including eating, smoking, injection and inhaling. Statistics published by international organizations such as UNDCP, WHO and UNSCO indicated an increasing trend in drug abuse worldwide. The countries are different only in the pattern of drug abuse. This study investigates the pattern of drug abuse in last 5 years in Ardabil. This is a descriptive, analytical and prospective study. To obtain the trend of substance abuse the records of all addicts in 1998 (684 cases) and 2002-2003 (341 cases) were studied. The collected data were analyzed by SPSS software (rel.11) using descriptive statistics. The findings indicated that in the last five years the use of hashish, opium extract and other substances has decreased whereas the trend of heroin and opium use has increased. The use of opium has increased from 48.07% in 1998 to 67.4% in 2002-2003. Also the heroin use has increased from 8.5% in 1998 to 27.5% in 2002-2003. Moreover, the use of hashish, opium extract and other narcotics has decreased. The highest decrease (23.5%) belonged to opium extract and the highest increase (19%) to heroin. According to the results we could say that the pattern of substance abuse in Ardabil in the last five years has changed and heroin and opium consumption has increased.

The hearing organ has a special role in establishing communication among people and their education. Hearing loss causes disorders in communication between human and environment. In growing ages, hearing loss may lead to general educational failure. T his study was conducted in order to determine the relationship between hearing loss and educational failurs. In this case control study 110 failed students in 5th grade elementary school (case) and 110 other ones (control) were selected by systematic random sampling. Both groups underwent the audiometric tests. The Data were analyzed by EPI 2000 software. The results of this study showed that 9.1% of cases and 0.9% of controls needed sonic energy more than 30db in left ear to hear. The difference was significant (P<0.05) whereas there was no significant relationship between hearing loss and educational failure in rigth and left ear in both groups when the sonic energy used is more than 20db. The failed students are strongly recommended to be annually examined and evaluted by a specialist and if necessary be treated.

Intestinal infestation is among the most common infections in the world, being responsible for considerable morbidity and mortality. The objective of this study was to determine the prevalence of intestinal infestation and related risk factors among students of primary schools in Ardabil.

This cross-sectional and descriptive study was conducted in 24 primary schools of Ardabil in 2003. A total of 1070 school children between 7-13 years of age (527(49.3%) boys and 543(50.7%) girls) took part in this study. Fecal specimens were collected by random sampling and were examined for ova, larva and cysts of intestinal parasites using direct wet mount and formalin-ether concentration methods.

A total of 1 0 species were identified, Giardia lamblia (14.2%), Blastocystis hominis (10.2%) and Entamoeba coli (4.1%) were the most common parasites, respectively, the over all prevalence rate for at least one parasite was 27.7%. There was no statistically significant difference in prevalence of parasites by sex, age, class grade and rate of infection (p>0.06).

This study indicated that there is a high rate of intestinal infestation rate among primary school students. So health education about personal hygiene is necessary for the students and their parents, especially mothers.

Regarding the high prevalence of hyperlipidemia in the world especially in Iran, finding suitable and effective treatment seems justified. Metronidazole is the only drug that is used as an antiparasital and antiprotozoal agent. Researchers have found that oral dose of 750 mg/day has a suitable absorption, is widely distributed in the tissues and reaches to a blood level of 4-6 mg/ml. Despite its suitable efficiency, a few clinical trial have been conducted in this regard. This study was designed as such to examine the effect of metronidazole on lowering blood lipids. The present research was performed as a clinical trial without control, on 50 patients. All the patients filled out a special form (to show their satisfaction) as well as a questionnaire. Metronidazole was given with a daily dose of 750 mg for a week. 20 patients with no complaint continued their drug consumption for another seven days. Lipid parameters such as plasma total lipid, total cholesterol, and triglyceride were measured in both groups. The data were collected and analyzed with SPSS software using t-test. Measuring the serum level of lipids indicated that the mean total plasma lipid and total cholesterol decreased significantly compared to their level before taking the drug (p<0.01). The findings also showed a similar decrease in plasma TG level (p<0.001). In the patients who continued the drug consumption in the second week, the serum level of lipids under study showed more decrease compared to their levels in the first week which was statistically significant (p<0.01). Liver tests indicated that the functioning of liver has not changed during drug consumption. Using 750 mg of metronidazole per day exerts a significant decrease in lipids fractions in a short time. Most cases of hyperlipidemia require a long-term treatment, hence metronidazole can be effectively used in the treatment of short-term hyperlipidemia.

Intestinal infestation is among the most common infections in the world, being responsible for considerable morbidity and mortality. The objective of this study was to determine the prevalence of intestinal infestation and related risk factors among students of primary schools in Ardabil. This cross-sectional and descriptive study was conducted in 24 primary schools of Ardabil in 2003. A total of 1070 school children between 7-13 years of age (527(49.3%) boys and 543(50.7%) girls) took part in this study. Fecal specimens were collected by random sampling and were examined for ova, larva and cysts of intestinal parasites using direct wet mount and formalin-ether concentration methods. A total of 1 0 species were identified, Giardia lamblia (14.2%), Blastocystis hominis (10.2%) and Entamoeba coli (4.1%) were the most common parasites, respectively, the over all prevalence rate for at least one parasite was 27.7%. There was no statistically significant difference in prevalence of parasites by sex, age, class grade and rate of infection (p>0.06). This study indicated that there is a high rate of intestinal infestation rate among primary school students. So health education about personal hygiene is necessary for the students and their parents, especially mothers.

Hearing disorders are the most common causes of pediatric communicative and functional disorders in the united states which result in communicative and learning disorders, educational failure and vast socio-economic problems. It is estimated that the incidence of hearing loss in pediatric population is 2-4% and otitis media, which is the second infectious cause after the ordinary cold, is the most common cause of hearing loss in children. Hearing loss is categorized into two distinct groups, namely conductive and sensorineural, the former being more common among children. Most of the causes for conductive hearing loss can be diagnosed and treated. Hence, majority of hearing loss cases can be prevented by taking appropriate measures. This study was performed to examine the incidence and common causes of hearing loss among school children in Ardabil. This cross-sectional study was performed on 1999 primary school boys and girls (grades 1-5). The data were collected through a questionnaire in the from of autoscopic examinations and Tuning Fork tests. 654 cases were referred to the audiometric and tympana metrics centers for further examinations as well as filling out the questionnaires. 483 (24.2%) students were definitely suffering from hearing loss. The data were analyzed through descriptive statistics and SPSS software. In this study, the hearing disorders of male students was more than female ones. The most common causes of conductive hearing loss in both sexes and all 5 grades was cerumen (50.3%) and the second cause was otitis media with effusion (34.6%). The incidence of sensorineural hearing loss was 1.86%. Hearing loss disorders in low socioeconomic households is high (44.1%). There was a meaningful relation between hearing loss disorders and positive family history, educational failure, social class and seasons (p=0.001). Hearing loss disorders are high during the cold seasons (73.90%). Regarding the high prevalence of hearing loss among school children, more extensive and interventional studies as well as wide ranging screening are required.

Postoperative nausea and vomiting is the most common complication of anesthesia with an approximate prevalence of 30% up to 70% (in high risk patients). In recent years several articles have investigated the effects of antiemetic and anesthetic drugs on postoperative nausea and vomiting, but the nonpharmacological methods, which are cost-effective and have no side effects, are rare. Since it is essential for patients to be on fast before surgeries which require general anesthesia, occurrence of dehydration and extra cellular fluid volume deficit and subsequently nausea and vomiting are expected and anticipated. Thus in this study the effect of preoperative intravenous fluid on postoperative nausea and vomiting was explored. This clinical trial study was performed in two experimental and control groups, with 30 subjects in each. Experimental group were given a 1- liter bolus of intravenous normal saline preoperatively in addition to routine IV fluid. Finally the incidence of postoperative nausea and vomiting was observed and compared between two groups. According to statistical tests, the differences between age, preoperative and postoperative NPO duration, use of antiemetics and the duration of hospitalization in two groups were statistically significant but the differences between other demographic variables and the volume of intraoperative intravenous fluid received during the surgery were not. Results showed that experimental group had significantly lower incidence of nausea and vomiting (20% and 10% respectively) in comparison with control group (50%). According to chi-square test, the rate of postoperative nausea and vomiting was significantly different in two groups. (p=0.015 and p=0.001 respectively) Also, preoperative NPO duration had significant relationship with postoperative vomiting (p= 0.05). Regarding the positive effect of intravenous fluid therapy on postoperative nausea and vomiting as a cost effective and harmless method in surgery, its use is recommended.

Depression is the most common psychological problem in patients with End-Stage Renal Disease (ESRD). The present study was conducted to determine the rate of depression in chronic hemodialysis (HD) patients. It was a descriptive cross-sectional study. 120 chronic HD patients who referred to dialysis ward of Shahid Beheshti Medical University (SBMU) hospitals were selected through an available (non-random) sampling and after exclusion of 20 patients due to study’s exclusion criteria, all were assessed for depression, using Beck’s Depression Inventory (BDI). Statistical analyses were preformed by SPSS (rel 11.5) using analysis of variance (ANOVA), independent t-test, Chi- Square and coefficient of correlation. Totally, considering the intensity of depression, 69% of patients were in depression spectrum (BDI>9), but the rate of depression was 45% (BDI >15) among chornic hemodialysis patients. There was no significant difference between the intensity of depression and various parameters, but unemployment associated with higher rate of depression (p=0.018). It seems the screening of HD Patients with BDI followed by referring the depressed patients to a psychiatrist for more evaluation is necessary so that at least some of the suffering, morbidity and mortality of the patients will be diminished.

Respiatory Distress Synderome (RDS) is one of the major risks of elective cesarian section whose negative health and econemical outcomes are obvious. Maternal prophylactic injection of corticosteroid drugs can reduce RDS of neonate to some extent. On the other hand corticosteroid drugs have some side effects such as delay in the healing of the incision. This study considered the effect of betamethasone on surgical incision. This study was conducted on 60 primipara women divied into two equal groups that were candidate for elective cesarean. We injected betamethasone (IM) to trial group twice 48 hours poior to operation, (every 24 hours) and complication of surgical incision was clinically evaluated within 7 days after operation in both groups. The data were collected and analyzed by SPSS software chi-square and Fisher tests. Most patients (60%) were 20-30 years old and the average age in both groups was 21. The relative frequency of patients with complication of surgical incision in trial group (betamethasone recipients) was 30% and in control group was 23.33% (the difference between them was not statistically significant). The most common complications were erythema and hyperemia. Other complications observed in 15% of the patients included serousal discharge, local warmness and enduration. Rgarding these complications also there wasn’t a statistically significant difference between two groups. Betamethasone does not increase early onest complications of surgical incision and we can safely use betamethasone prophylactically for fetal maturion in elective cesareans.

Authorities and scholars believe that determining cigarette smoking status of individuals and groups and finding reasons of smoking plays an important role in manipulating and facing with this dirty habit. The present study is an attempt to determine the rate of prevalence and the causes inducing smoking among students of Ardabil university of medical sciences. This survey was a descriptive and cross-sectional study. Of 1300 medical sciences students, 1106 ones volunteered to participate in this study. The data were collected using a questionnaire and were analyzed in SPSS. 154 students (13.9%) had experienced cigarette smoking previously and 82 students (7.2%) were already a smoker. Intimacy with smokers, self-gratification and acquiring enjoyment, educational failures, vague future career and smoking for entertainment were the most important factors inducing smoking. Cigarette smoking prevalence rate in this study was relatively low in comparison with similar studies. However, regarding the critical social status of these students, some serious measures should be taken to inform them about the dangers of smoking and at the some time some facilities should be provided for students, which can be of great help in this regard.

With due attention to the modern technology developments in medical sciences, human resource training and optimization looks necessary. Although its importance and necessity has been regarded by many investigatores and scientists and they have emphasized its accurate and comprehensive execution, unfortunately, the training of nurses has encountered some problems, the solution of which demands great attempts. This study has been done to determine the state of Continuous medical Education (CME) from the view of the nursing personnel working in the hospitals under Ardabil university of medical sciences in 2002. This descriptive study was conducted on 386 nursing personnel working in hospital under Ardabil university of medical sciences. A questionnaire was used to collect the data. The collected data were analyzed by SPSS software. 79% of the sample was female and 81.9% were nurses. 35.6% of them had not participated in CME courses. 28.6% of them had information about CME law. 25% found the lectures less practical and 56.5% of them appraised moderate the subjects presented. 60% of them believed in the positive influence of conferences in hospitals on their better functioning. 59.8 % said that their educational needs is not evaluated before the conference is held. 75.4% stated that new books in nursing are not available in the hospitals. 49.7% have appraised educational programs in the hospitals as moderate. 43.8% stated that the operation of modern medical equipment is not trained completely and only 4.6% said that specialists have scientific discussion with nurses. Overal, 55.2% of the nurses evaluated education by specialists as moderate. 50.8% of nurses assigned a moderate value to CME. It seems necessary to reconsider the subjects and the execution procedures and perform needs analysis prior to this education.

Tina capitis is among the most prevalent human infections induced by dermatophytes. Some dermatphytic factors are globally widespread while some others are geographically determined. A number of similar researches have been conducted in Iran however, due to the geographically diverse etiology of the disease and lack of similar research in Meshkin Shahr, the present study was conducted to determine the prevalence of tinea capitis in primary schools of this city. In order to determine the frequency of the tinea capitis in the students of primary school in Meshkin Shahr, children in 13 schools including 2470 boys and 3012 girls were studied. For this purpose first of all the children’s scalps were observed clinically and the specimens such as hair and scale were taken from 228 pupils. The specimens were examined by direct and culture methods. Of all the subjects, 38 students (0.7%) had tinea capitis. The prevalence rate was 0.8% and 0.6% among boys and girls respectively, which was statistically significant. The high degree of disease was seen in 11 year old students (39.5%) and the main source of infection was Trichophyton violaceum. Desptie a decrease in tinea capitis among children especially in primary school pupils nationwide, there is still a considerable (0.7%) rate of prevalence in Meshkin Shahr which demands attention.