مجله علوم پزشکی رازی
سال بیستم شماره 1 (پیاپی 106، فروردین 1392)

Due to the increase in C-section delivery, the percentage of natural delivery has decreased in recent years. This study aimed to investigate some of the factors which influence the choice of delivery type in women, working in Shahroud University of Medical Sciences. This applied cross-sectional study was conducted in 2012. All eligible women working at Shahroud University of Medical Sciences took part in the study and they completed a questionnaire including 9 demographic items and 37 specific items on the previous delivery condition. The collected data were fed into SPSS and analyzed through Chi-square test. The significance level in all tests was 0.05. The mean age of the participants was 37.62±7.38. 28.5% of the participants had experience of C-section delivery. 57.8% of the participants had C-section delivery in their previous delivery. No significant relationships were observed between level of education, occupation, place of job, employment status of the respondents and delivery type (p>0.05). However, there were significant relationships between delivery type and husband’s high level of education, experience of c-section, history of disease contraction, history of abortion, friends’ suggestion, delivery type of friends, delivery type suggested by the husband, delivery type suggested by mother, and doctors’ or obstetricians’ suggestion (p<0.05). The mean of C-section prevalence among service providers is higher than that among the society. It is suggested that the health policy makers in the city try to reform the attitudes and performance of this group through setting instructional meetings.

Consumption of some food groups such as fruits among students who are living in dormitories is inadequate. Given to the importance of recognizing effective factors of consuming fruit in this group, the present study aimed to determine daily fruit consumption status among girl students who are living in the dormitories of Tehran University of Medical Sciences and it determinants based on the theory of planned behavior constructs in 2011. In this descriptive-analytical study, a convenience sample included 200 girl students were selected by random sampling method and filled out questionnaires (including demographic variables, theory of planned behavior constructs and daily fruit consumption). Statistical analysis of data was performed with SPSS software, correlation, One-Way ANOVA and Regression analysis tests. The average age of participants was 22.6 years old. The level of education showed that 80% of participants were undergraduate. 55.5% of subjects ate one fruit or less, 30% two fruits and 10% three fruits per day. Only 4.5% of subjects ate 4 fruits and more per day. Behavioral intention alone was predicted 30% of the variation in daily fruit consumption (R2 =0.30, F =10, p<0.0001). By adding BMI and income variables to pervious regression model, prediction was increased to 42% (R2 =0.42, F =6.9, p<0.0001). Also, 54% of the variability in behavioral intention was predicted by the following variables: attitude and subjective norm constructs (R2 =0.54, F =40, p<0.0001). Fruit consumption in the students is inadequate. In designing nutrition education interventions aiming at increasing fruit consumption in this group, it is better to put more emphasis on strategies to promote behavioral intention, its predictive factors (e.g. attitude and subjective norms (and socioeconomic status and indicators such as body mass index of students.

Physical activity can cause various hematologic changes.The purpose of the present research was to examine the effect of a maximal aerobic exercise session in the morning and the afternoon on certain hematological factors in young male athletes. 20 athletes were randomly selected from the students of Physical Education in the University of Tehran and were divided into a morning group (N=10; 20.9±0.99 years, 67.35±6.27 kg, and 180.4±4.28 cm) and an afternoon group (N=10; 21±0.63 years, 67.13±9.13 kg, and 176.9±9.01 cm).The morning and afternoon groups performed the seven-station Bruce protocol from 8 to 10 A.M. and 3 to 5 P.M. respectively. The present research is quasi-experimental with a pretest-posttest design. Blood samples were collected from both groups before, immediately after, and 2 hours after the exercise. Mean and standard deviation were used for data description, and repeated measures ANOVA as well as Bonferroni test were applied for hypothesis testing at the 0.05 significance level. The result suggested significant differences in the levels of hemoglobin and erythrocytes of the two groups at different stages of blood sampling. No significant difference was observed in the level of hemoglobin and erythrocytes before and two hours after the exercise. Measurement of the level of leukocytes in the two groups and at different stages of blood sampling indicated significant differences, and both groups showed significant differences in the level of platelets at different stages of sampling (p≤0.05).Comparison of the two groups revealed that there is no significant difference between the morning and the afternoon group in the levels of hemoglobin, platelets, erythrocytes, and leukocytes before, immediately after, and two hours after the exercise. Based on the results of the research, it can be argued that a maximal aerobic exercise session in the morning and the afternoon changes the level of on certain hematological factors, and that the time of exercise has no effect on the amount of change. So for having an ideal feature in hematological parameters, which play a vital role in tissue safety and oxygen supply, should be considered in the performing activities.

Marriage is a phenomenon that changes the nature of sexual and reproductive health needs. Ignorance of natural differences of sexual and reproductive health needs in different situations reduces the effectiveness of training programs in this area. This research aimed to compare of sexual and reproductive health educational needs in two stages, before and after marriage in youth. In a cohort study in 2011, by random stratified sampling in males and females, 450 engaged youth that participated in pre-marital counseling in Tehran, were selected. The level of sexual and reproductive health educational needs was measured by a self designed questionnaire which was a 5-point Likert-scale in two stages before and after marriage. Data were analyzed by SPSS15. Descriptive Statistics, t-test and paired t-test were used. Means of educational need score before and after marriage were 3.56±0.95 and 3.72±0.82. After marriage, the level of sexual and reproductive health educational needs had increased but this wasn’t significant (p-value= 0.096). “Healthy sexual relationships" in before marriage and “best physical condition, mental and social sex for pregnancy" in after marriage were the most important educational topics. Findings suggest designing and implementation of sexual and reproductive health educational content based on needs of young people with regard to cultural and social situations of them is a must.

Internet is a safe tool but its extreme use leads into internet addiction that is classified as behavior-based addictions. The use of internet and the internet addiction is increased among students and university students. This study was done with the purpose of determining the knowledge condition, attitude and addiction to internet among BSc students of Tehran University of Medical Sciences. This descriptive-analytical study was done on 100 BSc students whom were selected by cluster sampling method. Data collection was a researcher-built questionnaire and its validity and reliability was achieved. The questionnaire was consisting of background questions of knowledge, attitude and behaviors of research units. The data was analyzed by SPSS software (version16) with the help of Chi-square test and Independent t- test. The mean knowledge and attitude score of the students was average (4 ± 1.8, 21.54 ±3.8).18% of the students had internet addiction behavior. There was a significant association between attitude scores and academic field (p= 0.013). Male student were more addicted to internet compared to female (13% to 5%). There was a significant relation between internet addiction behavior and its method and duration of use (p= 0.008, p=0.0001). The knowledge and attitude of the studied students are inadequate and the internet addiction behavior exists among them. Thus, education intervention designs by appropriate learning theories are proposed.

Autism spectrum disorder (ASD) is characterized by difficulty in the areas of social functioning, communication, and the presence of stereotypic and repetitive behaviors. Video modeling has been found to be an effective procedure for teaching a variety of skills to persons with autism. The purpose of the current study was to investigate the efficacy of video modeling procedure on self-help skills in children with Autism Spectrum Disorders. Present research is an experimental study of a single case. Four children (2 males & 2 females), ages 6–10, diagnosed with an autism spectrum disorder, participated in this study. A multiple baseline design for each participant and chart analysis for data analysis was used. Data analysis showed that the video modeling method on self-help skills in subjects effective. Results showed that likely the video modeling procedure increased self-help skills in children with autism spectrum disorders.

The aim of this study was to investigate the effect of muscle fatigue on ankle joint moment and center of pressure during single-leg stance, perturbed by forward or backward platform perturbations. In this semi-experimental study fatigue induced to knee muscles by using an ergometer (monark). Surface elecromyographic signals were recorded from knee muscles during maximal voluntary contraction, sustained contraction and perturbation before and after muscle fatigue. Moreover, using force plate and video camera system, force and motion signals were simultaneously recorded during perturbations before and after muscle fatigue. To assess muscle reflex activity, the average rectified value of individual muscles was calculated over a fixed window, which was 180-ms after the onset of plate movement. Inverse dynamic method, ankle joint moment and center of pressure computed from kinetic and kinematics data after the onset of plate movement. One way analysis of variance revealed that maximal knee extension contraction and muscle endurance (time to task failure) were significantly reduced after muscle fatigue (p< 0.05). Muscle reflex activities during post fatigue perturbations were significantly lower than the pre fatigue perturbations (p<0.05). A significant increase in ankle joint moments in the frontal and horizontal planes were also observed (p<0.05), which was accompanied by a significant increase in center of pressure in the frontal plane. The results of the current study demonstrated that muscle fatigue increases ankle joint moment and center of pressure in the frontal plane during single-leg stance, which in turn may increase the risk of lateral ankle injuries. These results partly explain that why lateral ankle sprains are common after heavy exercises.

As regard to high prevalence of Helicobacter pylori infection and complication of it,s persistence, as well as anti-bacterial activity against of it and anti-inflammatory properties of n-3 FAs, the present study was done with purpose of the effects of supplementation with EPA on the eradication of H.pylori, level of some serum inflammatory markers and total antioxidant capacity.

Inadouble-blind, placebo-controlled clinical trial, 64 H. pyloripositive patients (31 patients in intervention group and 33 patients in control group), along with tetra-drugs H.pylori eradication regimen, randomly received daily 2 grams EPA supplement or MCT oil as placebo for 12weeks. Dietary intake data was collected by 24hour food recall and analyzed by Nutritionist IV software. Fasting blood, weight, height and level of physical activity were sampled and measured at the first and the end of the study.

Distribution of sex and mean of age,weight,daily intake of energy,macronutrients, micronutrients related to antioxidant status, level of physical activity and biochemical variables, didn,t have any differences between 2groups at the first of the study. Furthermore, significant differences in weight, level of physical activity and daily food intake was not seen in any of 2 groups before and after study. Eradication rate of infection, the level of interleukin-6 (IL-6), interleukin-8(IL-8) and total antioxidant capacity (TAC) didnot have significant difference between 2 groups. The level of high sensitivity C-reactive protein (hs-CRP) statistically was decreased in EPA group (p=0.02).

12 weeks supplementation with EPA didnot have significant effect on eradication of H.pylori, serum level of IL-6, IL-8 and TAC,while it can decreases the level of hs-CRP.

Accurate estimation of medical costs is one of the health care policymaker's goals. Regarding to the feature of health data and the complexity of their analysis conventional models are not suitable for them. To model these data, all these characteristics should be taken into consideration. This study has estimated the average cost of gastrointestinal tract diseases and some factors influencing this cost using two part regression model. During 2006 to 2007 information of total 1907 gastrointestinal tract patients were collected in the research center for gastroenterology and liver disease of Shahid Beheshti University of medical science of Tehran as a retrospective cross-sectional study. For the purpose of modeling gastrointestinal tract disease cost, the two-part model was employed. In the first part, a logistic regression was fitted to the dichotomous events of having zero or positive expense and in the second part a multiple linear regression was fitted to positive expense and the effect of demographic variables, work ability, number of times visiting a doctor, the number of diagnostic tests, insurance, number of days absent from work or reduced efficiency and hospitalization on expense were assessed. The average costs of gastrointestinal tract diseases and their standard deviations in parametric method were yielded as $75.93±122.29. Minimum and maximum of costs were respectively estimated $2.89 and $1394.32. While the actual average cost was $78.35±222.36, minimum and maximum were respectively zero and $5183.81. The results obtained from the two- part model revealed that "some demographical variables", "number of days absent from work or reduced efficiency" and "number of times visiting a doctor" have influenced having expense and the variables "number of days absent from work or reduced efficiency", "number of times visiting a doctor" and " hospitalization" " have influenced positive expenses. The estimated cost made by this method is close to the true value. According to the lower standard deviation of estimations made by model, compared to the actual values, estimations from this model have high precision. In addition, this model has performed well to maximize zero costs.

Toxoplasmosis is a parasitic disease which may cause some laboratory symptoms in infected individuals. One of the main ways to transmit this organism is placenta to fetus pathway. If this transmission occur in the third month of pregnancy the abortion, central nerve system and ocular disorders will happen. Because of this issue, precise techniques such as ELISA & ELISA Avidity for detection of Toxoplasma Antibody (IgG and IgM) are important. The aim of this study was to detect the time of infection of mothers with toxoplasma gondii. The study method was evaluation assessment. In this survey, the main samples are serum and amniotic fluid that was collected from 48 pregnant women infected with toxoplasma gondii in Shariaty hospital. The statistical method was based on spss18 software. The results of this survey showed that, in these pregnant women the infection of toxoplasma gondii is occurred and many of them are infected currently and in both samples the mean of ELISA avidity titer elevated that was associated with number of abortion. In simple ELISA technique, the only antibody which can be detected precisely is IgM; but in this technique the IgG antibody is also detected. In this recent technique or ELISA AVIDITY, in addition to detection of IgG antibody against toxoplasma gondii, the month of transmission of toxoplasma is interpreted.