مجله دانشگاه علوم پزشکی شهید صدوقی یزد
سال بیستم شماره 6 (پیاپی 89، بهمن و اسفند 1391)

Sleep is an effective factor in the recovery processes. Many variables affect on the sleep quality of hospitalized elderly people. This study was conducted to determine the factors disturbing sleep quality among hospitalized older adult patients in Kashan hospitals. A cross-sectional study was carried out on a sample of 390 elderly hospitalized patients in Kashan hospitals. The study data was gathered via Pittsburgh Sleep Quality Index (PSQI) Questionnaire. A global total score of 5 or greater indicated a “poor" quality of sleep. The data were analyzed using Chi square, t- test and binary logistic regression at multivariate model. The total quality of sleep was poor in hospitalized elderly patients (7/2±4/8). Sex, marital status, level of education, type of ward, previous hospitalization experience, use of hypnotics at home and hospital, and previous sleep disorders were statistically associated with quality of sleep; however, there was not significant relationship between quality of sleep and age, length of hospitalization, and daytime napping. In the final regression model, marital status (OR=4.6), level of education (OR=1.9), length of hospitalization (OR=1.1), Previous hospitalization experience (OR=0.4), use of hypnotics in hospital (OR=0.27) and previous sleep disorder (OR=0.01) were the most important determinants of sleep quality. Quality of sleep was poor in hospitalized elderly due to a wide range of sleep disturbing factors. The most important factors involved marital status, level of education, previous hospitalization experience, previous sleep disorder and use of hypnotics in hospital.

Hand burn is a common and considerable cause of chronic disabilities, since it mostly causes functional disorders like a range of motion defects in hands. Therefore, this study aims to examine the effect of education regarding hand-burn caring on deformity as well as the range of motion disorders in hand- burn patients admitted to Shahid Motahari hospital in Tehran. This study is a clinical trial conducted on sixty burn patients. The subjects were randomly assigned into experimental and control groups. A systematic education program was implemented on the experimental group regarding how to care hand burn. The research data was gleaned by an observational checklist of hand deformity as well as a demographic questionnaire. The research data was analyzed via SPSS software version 10. Majority of patients were male aged 15-25 years with primary education who were village residents in a low economic status. The most common cause of burning was benzene with total burn surface %45- 36%. The study results revealed that the implementation of hand care educational program for hand burn patients was statistically effective on the hand deformity. Conclution: Implementing programs of hand burn is recommended to reduce the functional problems of the hand after burning. Therefore, the nurses need to attend to education in caring of these patients.

Nosocomial infection is a major challenge in health care system. In fact, it is regarded as one of the risk factors in hospitalized patients which results in a significant increase in mortality,morbidity and financial burden. Noscomial infection transmission via the hands of hospital personnel to patients is known as a primary method of transmission, however, revealing such effect to the healthcare workers in order to follow the proper behavior is somehow hard. Therefore, this study aimed to investigate the microbial contamination of nurse's hands regarding jewelry. This is a descriptive analytic study. The random sampling was applied which consisted of 50 nurses working in hospitals of Shahid Sadoughi Medical University of Yazd. Samples were collected at the beginning of the shift. In fact, a culture was taken using a cotton swab soaked with sterile water on the surface of the jewelry and the area under it immediately after the withdrawal. Moreover, the samples were gleaned as many as the number of jewelries from the other Hand or an area close to the position. The samples were analyzed utilizing SPSS software version 12. As the study findings indicate, most jewelries involved gold rings and gold Bracelets. Culture results were reported as 45.8% positive and 54.2% negative. Thus, there was no significant difference (p=0.33). For the below surface of jewelries, culture results were 64.6 % positive and 35.4% negative (P=0.000). Jewelry culture results for the opposite hand involved 64.6% positive and 35.4% negative (P=0.000). In general, the three comparisons showed a significant difference (P=0.000) The findings reveal that using jewelries increases pollution. In other words, this will increase the probabaility of nosocomial infections and pathogens transmission. Therefore, it is recommended to remove jewelry during patient care.

Nanosilver particles are one of the functional grounds in nanotechnology field. These nanoparticles may produce free radicals and destruct different cells. In this study, Nanosilver toxic effects on RBC and WBC numbers in male Rats were studied. Thus, male rats were treated with nanosilver and RBC and WBC were detected. In this study, RBC was detected in male Wistar rats following exposure to 50, 100, 200 and 400ppm concentration of silver nanoparticles administrated peritoneally. Then, RBC and WBC were collected in rats 3, 8 and 12 days after treatment of nanosilver particles. Numbers of RBC and WBC were compared in treatment and control groups. The study results indicated that dose of 400ppm nanosilver was effective on decrease of RBC and increase of WBC in treatment rats 12 day after treatment. These results were significant (p≤0/01). The efficiency of 400ppm concentration of nanosilver, RBC decease and WBC increase could be referred to probabale lyses of RBC cell membranes and sever incitement of cellular immune system. The extra investigation is recommended regarding variety of new shapes, sizes and composition of nanosilver.

Prolonged exposure to electromagnetic fields (EMF) influences digestive system specially its motility. The present study was performed in order to study the effects of exposure to low frequency EMF on the adrenergic system of large intestine. In this experimental study, thirty adult male rats were divided into three groups: First group (experimental) included 10 male rats that were exposed to 1000µT and 50Hz for 140 days in the on solenoid. Second group (shahed) included 10 rats that were kept at same condition as the first group except that the solenoid was off. Third group (control) included 10 rats that were kept in a normal condition. Mechanical activity of the isolated strips of colon that were inserted to organ bath contained Kerebs solution(CaCl2 2/5, KCL 4/7, KH2Po41/2, MgSo4 1/2, NaHCO3 25, NaCl 118, glucose11, PH=7.4) (37°C) and they were linked to power lab force transducer to record cumulative doses of Phenylephrin. The data was analyzed using t- test at p<0.05 as a significant level. The results showed no significant difference regarding long- term exposure to low frequency Electromagnetic field on adrenergic receptor α 1 adrenergic receptor sensitivities.

Clinical evaluation of iodine deficiency disorders (IDDs) is often accomplished by assessment of urinary iodine excretion (UIE) in random samples; however, the utilization of 24 hour urine samples is a more reliable biomarker of nutritional iodine status. This study was designed to evaluate total goiter prevalence (TGP) and iodine/creatinine ratio among school-aged children in Urmia County.

Schoolchildren (n=500) were recruited by cluster sampling from different educational areas in Urmia County. Goiter prevalence was assessed by thyroid palpation, UIE was determined by Sandell-Koltoff reaction, and Urinary creatinine was measured by the Jaffe-method.

In general, TGP was 12.2%. Among these, there were 48 individuals (9.6%) with grade I goiter and 13 subjects (2.6%) with grade II goiter. Mean urinary creatinine, median UIE and median I/Cr ratio were respectively 1.36±0.76 mg/dL, 14.3µg/dL, and 11.5µg/mg. Prevalence of iodine deficiency according to UIE criteria was 22.8% and that of I/Cr ratio was 41.2%. There was a correlation between age and UIE (P=001; r=0.163). UIE and urinary creatinine were correlated as well (P<0.003; r= 0.133). A correlation was also detected between I/Cr ratios and UIE (P=0.003; r=0.133) whilst a negative association was seen between age and I/Cr ratios (P=0.001; and r=–0.263).

This investigation reconfirms that there is slight-to-mild iodine deficiency in Urmia County. The utilization of I/Cr ratio in conjugation with UIE and palpation may provide a better assessment in investigating nutritional iodine status.

Needle stick injury is known as a common adverse complication that health care staff are encountered with. This injury cause different pathogen to be transmitted through blood. So investigating the knowledge and practice of health care staff can be useful and beneficial. In this descriptive study, the study data was collected via a questionnaire that consisted of demographic characteristics, knowledge and practice of staff about needle stick injury. Descriptive statistics, ANOVA, T test, Pearson coloration and Scheffe Test were used to analyze the data. Data analysis showed that mean of knowledge score of men and women were 5.70 and 5.75 respectively. There was also no significant difference in age, sex, working experience and the mean of knowledge scores between the different groups (p = 0.412). In addition, results showed that there was no significant difference in the mean of knowledge scores among different ward staff (p<0.001). The study findings indicate that educational plan should be provided regarding safe injection and preventing approaches.

Studies reveal that there is an association between smoking and serum levels of sexal steroid hormones. The main aim of this study was to determine the effects of cigarette or waterpipe smoking on serum level of LH, FSH, and testosterone in male rats.

Male Wistar rats were randomly divided into control, cigarette, and waterpipe smoking groups, each consisting of 10 participants. After 6 weeks, blood samples were collected using cardiac puncture method. Following serum collection, levels of LH, FSH or testosterone were measured by radioimmunoassay method. Data were statistically analyzed and compared between groups using ANOVA.

The results indicated that serum FSH level was significantly increased in cigarette smoke and waterpipe smoke receiving rats compared with control ones (P<0.001). Serum levels of testosterone were decreased in cigarette or waterpipe smoke groups in comparison with control animals (P<0.001). Furthermore, Serum level of LH was not significantly changed in waterpipe and cigarette smoke receiving rats.

Our finding indicated that there was no significant difference between effects of cigarette and waterpipe smoke on serum testosterone, FSH and LH levls.

Teleworking is a kind of method in which works are performed utilizing telecommunicating tools time and location free. The current study aimed to have quick survey on merits and demerits of implementing teleworking project in Iran's governmental organizations. Furthermore, it intends to design a model for teleworking implementation in Ministry of Health and Medical Education (MoH&ME).

This is a descriptive and analytical study and its variables are also qualitative. Since in this study no occupation in MoH & ME couldnot (1000 percent) be purely teleworked, a teleworking applicant form was devised as the research to be filled by teleworking appliers. Afterwards, their teleworking applicant form was evaluated; having passed from the required filters, their teleworking would be accepted or rejected.

According to the duty description of MoH&ME's occupations, it was clarified that the only 78 out of 250 job positions could be done by teleworking provided the required conditions as well as the reconsideration of duty descriptions were satisfied. Indeed the study results regarding the job positions of Human Resource Management Office showed that from total of 46 job positions in this office, only 22% can be done through teleworking method. Regarding teleworking appliers charactristics in MoH&ME during 2 months period, 3% of MoH & ME personnel applied teleworking and within them, 27% were male and 77% were female.

Implementation of teleworking could increase productivity, quality of work life and decrease costs and personnel transportation bulk, however for effective implementation, first jobs should be reconsidered, then necessary technical capacity and also motivated human resources should be provided, otherwise a disorder might occur in performing the affairs.

It is important to predict mesiodistal crown width of the unerupted permanent canine and premolars in the mixed dentition, which helps to better determine malocclusion and its further development. In this study, 120 pair of dental study casts, belonged to subjects aged between 12-30 years, were selected and measured in the most mesiodistal width of permanent canines and premolars of both jaws, lower permanent incisors, and first upper permanent molars with the accuracy of 0/01 mm. Mesiodistal width of permanent canine and premolars in upper and lower jaws were estimated by new formula based on the permanent first upper molars and lower central incisors and then were compared with Tanaka-johnson formula. The actual mean for sum of the mesiodistal width of permanent canines and premolars in the upper jaw was 21/22 mm and in the lower was 20/98 mm. The mean for sum of mesiodistal permanent canine and premolars were estimated by new formula in upper and lower jaw as 21/64 mm and 21/69 mm respectively. On the other hand, via Tanaka-Johnson formula, the predictions in upper and lower jaw were 22/41 mm and 21/92 mm respectively. Statistical analyses by means of ANOVA and Pearson correlation test revealed significant differences (P<0.001, r = 0.701). Sum of mesiodistal width of unerupted permanent canines and premolars teeth in the Iranian race (in Yazd) was estimated better using the new formula than applying the Tanaka Johnson formula, because of two following reasons: first, the new formula can be used at an earlier age and second, it has a higher accuracy.

There are few studies regarding the field of catalase gene expression, antioxidant and oxidant response in trained women, thus these markers’ levels have not been designated within Iranian trained women specially in regard to incremental exercise. Therefore, this study aimed to investigate Catalase enzyme Gene expression and oxidant levels in trained women. A repeated measure design was used for this study. Fourteen trained young women in the age range of 23-25 years from urmia city were volunteered as subjects. Venous blood samples were taken in three stages, before GXT exercise test (graduate exercise test) (speed: 7/5 mile, slope grade: 6%, exercise time: 30 minutes), immediately and 3 hours after exercise. Real time PCR method was used for analysis of the mRNA of Catalase gene expression and the eutoanalyzer method was also applied for measurement of MDA activity. MDA (Malondealdeide) levels increased immediately and 3 h after exercise, though it proved to be statistically significant only in recovery stage (3 h after exercise) (P<0/002). Catalase gene expression significantly increased after exercise, but this difference wasn’t significant in recovery stage (P<0/03). Also, TAS (total antioxidant status) concentration increase was significant after training exercise (P<0/031), though it reduced in 3h after exercise (P>0/065). Incremental exercise test has increased catalase gene expression and antioxidant and free radicals levels in trained women.

Hearing is one of the premier human senses. Being deprived from hearing is not only being unable to hear the sounds, but it is also the disability to gain a lot of helpful experiences. Cochlear implantation is introduced worldwide in order to treat the severe to profound hearing loss. Therefore, the present study aims to determine the effect of age of cochlear implantation on improvement of the auditory performance. The present follow-up study was conducted on 96 children who had referred to Fars Cochlear Implantation Center. The patients’ information was gathered from their profiles both before and after the operation. In addition, the auditory performance score was obtained in 3 stages – 6 months, 1 year, and 2 years after the implantation – through the Cap test. Also, non-parametric tests of Fridman, Willcoxon, and Mann-Withney U were utilized in order to analyze the data of the study. The mean of the children’s auditory performance 6 months, 1 year, and 2 years after the implantation was measured as 2.8+1.03, 4.36+1.04, and 5.34+1.02, respectively. Besides, the median of their auditory performance 6 months, 1 year, and 2 years after the implantation was calculated as 3, 5, and 5, respectively. Also, a statistically significant relationship was observed between the independent variable of age of cochlear implantation and the auditory performance score 6 months, 1 year, and 2 years after the implantation. In line with other studies conducted on the issue, the present study showed the improvement of the auditory performance in the children who benefited from cochlear implantation. Moreover, the results of the present study revealed that the age of cochlear implantation can be of great help in determining the candidates of cochlear implantation. In other words, it can be a major prognostic factor of the response to the treatment

Renal artery stenosis is the most prevalent disease of renal artery and has an important role in making hypertension and renal atrophy. Since in previous researches, despite high frequency of risk of cardiovascular disease in Iran, there did not exist any general research investigating risk factors of coronary artery disease and incidence of contemporary renal artery stenisis, this study intended to investigate these factors in hypertensive patients in Iran.

This cross-sectional study was performed on 264 patients who were hypertension candidate for coronary artery angiography in Afshar hospital in Yazd. At the time of coronary angiography, patients had renal angiography at the same time. Among those patients, those who had coronary artery disease were selected and thus prevalence and severity of renal artery stenosis and its relationship with cardiovascular risks were investigated. The gathered data were analyzed by Spss-18 software.

Prevalence of renal artery stenosis (equal and over 50%) was 38.25 in all patients; in other words, in men and women it was 43.56% and 56.44% (P=0.04) respectively. Prevalence of co-morbidity of coronary artery disease and renal artery stenosis with 1 vessel disease was 34%, 2 vessel disease was 57.14% and 3 vessel disease was 54.17% with significant differences (P>0.01)

According to high prevalence of renal artery stenosis in hypertensive patients and high prevalency with simultaneous hypertension and coronary artery disease, renal angiography after coronary angiography may assist for unknown renal artery stenosis and better treatment.

Glycemic control in type 2 diabetic patients seems to be affected by personality as well as psychological factors. Therefore, this study intends to investigate the relationship between self efficacy, type D personality and health locus of control with control of blood sugar in patients with diabetes type 2. All women with diabetes in Yazd Diabetes Research Centre were considered among which 80 were selected by random sampling. They completed Shirer’s self-efficacy scale questionnaire, type D personality questionnaire and Multiple health locus of control questionnaire. Then they were introduced to the lab for blood test. Data was analysed by SPSS software and stepwise regression method. The results of Pearson correlation coefficients showed that self efficacy (r = 0/83) and type D personality (r=0/55) and health locus of control with HbA1c correlated positively and significantly (p <0/05). Stepwise regression analysis showed that R2=0/73; In other words, 73% changes of the variable HbA1is determined by self-efficacy, type D personality and health locus of internal control variables Impact of personality and psychological variables in diabetes glycemic control is important. So we can implement interventions to increase the efficacy of internal control sites and modify the features of type D personality in patients with diabetes and thus to improve glycemic control and adherence to treatment regimens in these patients.

The Bombay (Oh) Phenotype is a rare blood group. Phenotypes of this group lack H antigens on their red blood cell membrane and have strongly reactive anti-H in the serum for which patients can receive only autologus or Bombay phenotype red blood cells. We report three cases with Bombay blood group in the city of Yazd to emphasize the transfusion challenges in such patients