فهرست مطالب

Iranian Red Crescent Medical Journal
Volume:17 Issue: 1, Jan 2015

  • تاریخ انتشار: 1393/11/12
  • تعداد عناوین: 20
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  • Saeedeh Yarjou, Omid Sadeghpour, Esmail Nazem, Amir Hossein Emami * Page 1
    Background
    Nutritional deficiency, bleeding, and inflammation are three main causes of anemia. On the other hand, erythropoietin (EPO) production, iron availability, and a healthy bone marrow are essential for erythropoiesis. Recently, recombinant human erythropoietin (rhEPO) has been used to treat the patients already taking iron supplements. In Iranian traditional medicine literature, much has been written about anemia and its treatment..
    Objectives
    This study aimed to review Iranian traditional medicine theories in the treatment of anemia..
    Materials And Methods
    In the present study, authors have attempted to find the etiology and pathogenesis of anemia in Iranian traditional Medicine Literature and the views of ancient physicians in this field..
    Results
    Our findings proved that Iranian traditional medicine defined anemia as blood humor production dysfunction, which is caused by several reasons mainly hepatic dysfunction. Thus, liver is supposed to be the most important organ in this regard. This will make considering hepatoprotective medicines in anemia even in patients with non-hepatic problems..
    Conclusions
    The article presents the relation between anemia and liver dysfunction viewed by Iranian traditional medicine as an important finding in designing a treatment plan. Despite the new findings on the evaluation of liver function (i.e. laboratory tests), it seems that further studies for earlier evaluation of liver function in anemia are highly required..
    Keywords: Anemia, Traditional Medicine, Liver Diseases
  • Hadi Sharouny *, Prepageran Narayanan Page 2
    Introduction
    Frontal sinus mucoceles are the commonest among all paranasal mucoceles. With introduction of functional endoscopic sinus surgery, surgeons prefer endoscopic management of sinus mucoceles, but lesions that appear in the lateral part of the frontal sinus can be difficult to access and often need external approaches..
    Case Presentation
    We described a lateral frontal sinus mucocele with intra-orbital extension, which was successfully managed by endoscopic sinus surgery..
    Conclusions
    Endoscopic sinus surgery is the treatment of choice in most frontal sinus mucoceles including lateral frontal mucoceles..
    Keywords: Frontal Sinus, Mucocele, Endoscopy, Paranasal Sinus Diseases
  • Ehsan Zarei, Abbas Daneshkohan, Roghayeh Khabiri, Mohammad Arab * Page 3
    Background
    The trust is meant the belief of the patient to the practitioner or the hospital based on the concept that the care provider seeks the best for the patient and will provide the suitable care and treatment for him/her. One of the main determinants of patient’s trust is the service quality..
    Objectives
    This study aimed to examine the effect of quality of services provided in private hospitals on the patient’s trust..Patients and
    Methods
    In this descriptive cross-sectional study, 969 patients were selected using the consecutive method from eight private general hospitals of Tehran, Iran, in 2010. Data were collected through a questionnaire containing 20 items (14 items for quality, 6 items for trust) and its validity and reliability were confirmed. Data were analyzed using descriptive statistics and multivariate regression..
    Results
    The mean score of patients'' perception of trust was 3.80 and 4.01 for service quality. Approximately 38% of the variance in patient trust was explained by service quality dimensions. Quality of interaction and process (P < 0.001) were the strongest factors in predicting patient’s trust, but the quality of the environment had no significant effect on the patients'' degree of trust..
    Conclusions
    The interaction quality and process quality were the key determinants of patient’s trust in the private hospitals of Tehran. To enhance the patients'' trust, quality improvement efforts should focus on service delivery aspects such as scheduling, timely and accurate doing of the service, and strengthening the interpersonal aspects of care and communication skills of doctors, nurses and staff..
    Keywords: Health Care Quality, Patient Trust, Hospital, Patient Relation
  • Shahram Agah, Farzad Shidfar, Nafiseh Khandouzi *, Ahmad Reza Baghestani, Sharieh Hosseini Page 4
    Background
    Helicobacter pylori infection is the most common chronic bacterial infection around the world and an important cause of gastrointestinal disorders, which might be involved in the pathogenesis of some extragastrointestinal disturbances as well as changes in serum lipid profile. Hypolipemic properties of omega-3 fatty acids have been studied in several studies..
    Objectives
    The present study aimed to compare the effects of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) supplementation on the level of serum lipoproteins in H. pylori..Patients and
    Methods
    In a randomized, double-blinded, placebo-controlled clinical trial in Iran, 105 Helicobacter pylori were randomly allocated to receive 2 g of daily EPA (35 patients), DHA (35 patients), or medium-chain triglyceride (MCT) oil as placebo (33 patients) along with conventional tetra-drug H. pylori eradication regimen for 12 weeks..
    Results
    From 105 included patients, 97 (31 in EPA, 33 in DHA, and 33 in control groups) completed the study and were included in final analysis. The levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and the ratios of TG/HDL-C, TC/HDL-C, and LDL-C/HDL-C were not significantly different among the three groups, while the level of triglyceride (TG) was statistically different. DHA (-16.6 ± 30.34) and control (+ 15.32 ± 56.47) groups were statistically different with regard to changes in TG levels (P = 0.000)..
    Conclusions
    There was no difference between the effects of 2 g of EPA or DHA supplementation for 12 weeks on the levels of total cholesterol, LDL-C, HDL-C, TC/HDL-C, TG/HDL-C, and LDL-C/HDL-C; however, it had a desirable effect on the level of TG in a way that the effect of DHA was clearer..
    Keywords: Helicobacter pylori, Eicosapentaenoic Acid, Docosahexaenoic Acid, Cholesterol, Triglyceride
  • Mehdi Zanganeh Baygi, Hesam Seyedin *, Masoud Salehi, Mehdi Jafari Sirizi Page 5
    Background
    In recent years, family physician plan was established as the main strategy of health system in Iran, while organizational structure of the primary health care system has remained the same as thirty years ago..
    Objectives
    This study was performed to illustrate structural and contextual dimensions of organizational structure and relationship between them in Iranian primary health care system at local level..
    Materials And Methods
    A cross-sectional quantitative study was conducted from January to June 2013, during which 121 questionnaires were distributed among senior and junior managers of city health centers at Medical Sciences universities in Iran. Validity of the questionnaire was confirmed by experts (CVI = 0.089 and CVR more than 0.85) and Cronbach α was utilized for reliability (α = 0.904). We used multistage sampling method in this study and analysis of the data was performed by SPSS software using different tests..
    Results
    Local level of primary health care system in Iran had mechanical structure, but in contextual dimensions the results showed different types. There was a significant relationship between structural and contextual dimensions (r = 0.642, P value < 0.001). Goals and culture dimensions had strongest effects on structural dimensions..
    Conclusions
    Because of the changes in goals and strategies of Iranian health system in recent years, it is urgently recommended to reform the current structure to increase efficiency and effectiveness of the system..
    Keywords: Health Services Administration, Organizational Structure, Organizational Culture, Primary Health Care, Iran
  • Reza Hosseinabadi, Sadegh Jafarzadeh * Page 7
    Background
    The Auditory steady state response (ASSR) provides a frequency-specific and automatic assessment of hearing sensitivity and is used in infants and difficult-to-test adults..
    Objectives
    The aim of this study was to compare the ASSR thresholds among various types (normal, conductive, and sensorineural), degree (normal, mild, and moderate), and configuration (flat and sloping) of hearing sensitivity, and measuring the cutoff point between normal condition and hearing loss for different frequencies..Patients and
    Methods
    This clinical trial was performed in Iran and included patients who were referred from Ear, Nose, and Throat Department. A total of 54 adults (27 with sensorineural hearing loss, 17 with conductive hearing losses, and 10 with normal hearing) were randomly chosen to participate in our study. The type and degree of hearing loss were determined through testing by otoscopy, tympanometry, acoustic reflex, and pure tone audiometry. Then the ASSR was tested at carrier frequencies of 500, 1000, 2000, and 4000 Hz..
    Results
    The ASSR accurately estimates the behavioral thresholds as well as flat and sloping configurations. There was no correlation between types of hearing loss and difference of behavioral and ASSR thresholds (P = 0.69). The difference between ASSR and behavioral thresholds decreased as severity of hearing loss increased. The 40, 35, 30, and 35 dB could be considered as cutoffs between normal hearing and hearing loss for 500, 1000, 2000, and 4000 Hz, respectively..
    Conclusions
    The ASSR can accurately predict the degree and configuration of hearing loss and discriminate the normal hearing from mild or moderate hearing loss and mild from moderate hearing loss, except for 500 Hz. The Air-conducted ASSR could not define the type of hearing loss..
    Keywords: Auditory Steady State Response, Behavioral Audiometry, Sensory Threshold
  • Mohammad Mahdi Ahmadian-Attari, Abolhassan Ahmadiani, Mohammad Kamalinejad, Leila Dargahi, Meysam Shirzad, Mahmoud Mosaddegh * Page 8
    Background
    Alzheimer’s disease (AD) is a progressive neurodegenerative disease with a high prevalence in recent years. Dramatic growth in AD prevalence has increased the importance of more researches on AD treatment. History has shown that traditional medicine can be a source of inspiration to find new therapies..
    Objectives
    This study tried to codify the recommendations of Iranian traditional medicine (ITM) by studying the main medical manuscripts. The second purpose was to compare these findings with new medical information..
    Materials And Methods
    Cardinal traditional medical and pharmacological texts from 10th to 18th century were searched for traditional terms of dementia (Nesyan, Fisad-uz-Zekr, Faramooshkari) focused on treatment methods. The findings were classified into three groups: lifestyle recommendations, dietary approaches, and drug therapies. These findings were compared with new medical findings..
    Results
    ITM has dietary recommendations for dementia such as increasing consumption of nuts, poultry and eggs, milk, and grape products (like raisin and currant). These compounds are full of unsaturated fatty acids, cholesterol, and polyphenolic compounds. New findings suggest that these substances can help in prevention and treatment of AD. ITM has some lifestyle considerations like increasing physical and mental activities, listening to music, attending musical feasts, and smelling specific perfumes. New medical findings confirm nearly all of these recommendations. Along with the aforementioned items, treatment with natural medicines is in the first line of traditional treatment of dementia. New investigations show that many of these herbs have antioxidant, anti-inflammatory factors and acetylcholine esterase inhibitory effects. A few of them also have N-methyl-D-aspartate (NMDA) blocking activity. When these herbs are put together in traditional formulations, they can comprehensively fight against the disease..
    Conclusions
    More ethnopharmacological and ethnomedical studies on ITM antidementia therapy can be followed by fruitful results..
    Keywords: Alzheimer's Disease, Traditional Medicine, Diet, Lifestyle
  • Zahra Hashemi Dehaghi, Abbas Sheikhtaheri *, Fariba Dehnavi Page 9
    Background
    The association between quality of work life and participation in knowledge management is unknown..
    Objectives
    This study aimed to discover the association between quality of work life of nurse managers and their participation in implementing knowledge management..
    Materials And Methods
    This was a correlational study. All nurse managers (71 people) from 11 hospitals affiliated with the Social Security Organization in Tehran, Iran, were included. They were asked to rate their participation in knowledge management and their quality of work life. Data was gathered by a researcher-made questionnaire (May-June 2012). The questionnaire was validated by content and construct validity approaches. Cronbach’s alpha was used to evaluate reliability. Finally, 50 questionnaires were analyzed. The answers were scored and analyzed using mean of scores, T-test, ANOVA (or nonparametric test, if appropriate), Pearson’s correlation coefficient and linear regression..
    Results
    Nurse managers’ performance to implement knowledge management strategies was moderate. A significant correlation was found between quality of work life of nurse managers and their participation in implementing knowledge management strategies (r = 0.82; P < 0.001). The strongest correlations were found between implementation of knowledge management and participation of nurse managers in decision making (r = 0.82; P < 0.001)..
    Conclusions
    Improvement of nurse managers’ work life quality, especially in decision-making, may increase their participation in implementing knowledge management..
    Keywords: Job Satisfaction, Knowledge Management, Nurse Administrators
  • Hamid Gharaee, Masoud Shafiee, Rafie Hoseini, Mojtaba Abrishami *, Yalda Abrishami, Mostafa Abrishami Page 10
    Background
    The angle kappa is important in proper centration of corneal ablation in keratorefractive surgery. Orbscan II device is widely used preoperatively in photoablation surgeries and can be used to measure the angle kappa..
    Objectives
    This study aimed to determine the mean angle kappa and its intercepts in healthy young Iranian adults..Patients and
    Methods
    In this cross-sectional study, orthotropic patients (age range, 18-35 years) who were referred to the Khatam Eye Hospital (Mashhad, Iran) were included. Exclusion criteria were as follows: history of any eye deviation or strabismus with or without orthoptic or surgical treatment; any intraocular, corneal, or keratorefractive surgery; contact lens use; any corneal anomaly; any ophthalmic or systemic drug consumption; and hyperopic spherical refraction > + 3.00 diopters (D), spherical refraction > -5.00 D, or cylindrical refraction > 2.00 D. All of the parameters were measured by the same operator through an Orbscan II device..
    Results
    A total of 977 healthy participants who aged 18 to 45 years were included consecutively. The study population consisted of 614 females and 363 males. The average angle kappa was 5.00º ± 1.36º at 240.21º ± 97.17º in males and 4.97º ± 1.30º at 244.22º ± 94.39º in females (P = 0.63). The average horizontal (x-axis) angle kappa was -0.02º ± 0.49º, with a mean of -0.02º ± 0.50º in males and -0.02º ± 0.49º in females (P = 0.93). The average vertical (y-axis) angle kappa was -0.09º ± 0.32º, with a mean of -0.09º ± 0.33º in males and -0.09º ± 0.32º in females (P = 0.74)..
    Conclusions
    By using the normal angle kappa determined in this study, pseudodeviations can be identified more precisely in those who might undergo keratorefractive surgery..
    Keywords: Normal Value, Population, Refractive Surgical Procedures
  • Mahboobeh Kafaei Atrian, Zohre Sadat, Mahbobeh Rasolzadeh Bidgoly, Fatemeh Abbaszadeh *, Mohammad Asghari Jafarabadi Page 11
    Background
    Pregnancy is one of the most critical periods in women''s lives. Sexual relationships change in this period. Monitoring of uterine contractions has been shown increase in uterine activity after sexual intercourse in pregnant women..
    Objectives
    This study aimed to determine the association of sexual intercourse during pregnancy with labor onset..Patients and
    Methods
    This cross-sectional study included 120 pregnant women with signs of labor onset at referral hospitals of Kashan University of Medical Sciences between November and March 2012. Signs of labor onset included labor pain, bloody show, or rupture of membrane. Subjects were investigated in two groups regarding history of coitus in the last week of pregnancy. A questionnaire containing demographic questions, obstetrical history, and sexual activity was completed by trained midwife through face-to-face interview. Chi-square test, Fisher''s exact test, and t-test were used to check the homogeneity of the two groups for basic and confounding variables. Independent-samples t-test was used to compare differences between groups in terms of mean gestational age..
    Results
    There was no significant difference between groups in age (P = 0.434), body mass index (P = 0.705), neonatal weight (P = 0.421), maternal education (P = 0.963), occupation (P = 0.381), and parity (P = 0.925). Gestational age at the time of delivery was significantly lower in intercourse group in comparison with control group based on last menstrual period (P = 0.012) and ultrasonography (P = 0.002). There was no correlation between intercourse and cause of admission (P = 0.720). Type of delivery (cesarean section or vaginal delivery) was not affected by intercourse (P = 0.820) or contact with semen (P = 0.841). Results showed no significant difference in neonatal weight based on presence of sexual intercourse (P = 0.422) or contact with semen (P = 0.583) at the last week of pregnancy..
    Conclusions
    Sexual activity in last week of pregnancy might be associated with the onset of labor. Therefore, in the absence of complications in term pregnancy, sexual activity can be considered as a natural way to prevent post term pregnancy..
    Keywords: Coitus, Pregnancy, Gestational Age, Labor Onset
  • Masoomeh Rahmanian, Mohammad Kargar * Page 12
    Background
    Multiple sclerosis (MS) is an immune-mediated disease of polygenic etiology. Tumor necrosis factor-α (TNF-α) microsatellite as a proinflammatory cytokine is believed to play an important role in the etiology of this disease..
    Objectives
    The aim of this study was to investigate the association of TNF-α microsatellite sequence variation in patients with MS and its risk factor in the southern Iranian population..Patients and
    Methods
    This polymorphism was investigated in an Iranian population of 163 native southern people [81 patients with MS according to the poser criteria and 82 healthy controls (HC) with the same age, sex, social, ethnical and geographical features (Hormozgan and Fars provinces)]. All the controls were nonimmunological, neurological patients. All the cases and controls were chosen randomly and genotyped for polymorphism of TNF-α microsatellite..
    Results
    The frequencies of TNF-α*11 (0.25, P < 0.005) and TNF-α*10 (P < 0.005) alleles increased in patients with MS compared with controls, showing a significant difference among the studied population..
    Conclusions
    The current study adds evidence to the association of TNF-α gene polymorphism and MS in this southern south Iranian population which is consistent with the genetic analysis of MS in Europeans (GAMES) project reports and these two alleles reported in this study may be one of the genetic risk factor for MS. Furthermore, this data can be used to build the Iranian gene bank for future studies..
    Keywords: Tumor Necrosis Factor, Alpha, Multiple Sclerosis, Sclerosis
  • Mohammad Hadi Imanieh, Ali Goli, Mohammad Hossein Imanieh *, Bita Geramizadeh Page 13
    Background
    Geographic information system (GIS) software has been used in health care systems to display and analyze spatial pattern of diseases and health services..
    Objectives
    This study was performed to assess spatial patterns of colon’s pathologic lesions based on the pathologic reports and assess whether it is possible to use GIS software in health services..Patients and
    Methods
    Archives of pathology of Namazi and Faghihi hospitals, two main referral centers of south-west of Iran, were obtained and reviewed between January 2009 and September 2011 for biopsy reports of patients who underwent colonoscopy. Abnormal biopsies were categorized into five different subgroups according to the type of pathologic specimens. By GIS, spatial patterns of colon biopsies were plotted in different maps and spatial auto-correlation of colon biopsies was calculated using the Moran’s Index..
    Results
    A total of 4815 biopsies from 2663 different patients were reviewed, 53.8% of which were men. Abnormal biopsies were 2781 of all specimens (57.8%). Neoplastic lesions, inflammatory bowel diseases and polyps were 9.3%, 19.3% and 29.2% of total biopsies, respectively. Pathologic biopsies were more common in the distal colon. Maps of all biopsies and maps of specific pathologies were manifested in GIS..
    Conclusions
    Our study showed that left-sided lesions are still more common in the Iranian population. On the other hand, surveying the right side of colon is as important as the distal part, which necessitates total colonoscopy..
    Keywords: Geographic Information systems, Colonoscopy, Colorectal Neoplasms, Inflammatory Bowel Diseases, Colonic Polyps
  • Ali Sarabi-Asiabar, Mehdi Jafari, Jamil Sadeghifar *, Shahram Tofighi, Rouhollah Zaboli, Hadi Peyman, Mohammad Salimi, Lida Shams Page 14
    Background
    Identifying and employing appropriate learning styles could play an important role in selecting teaching styles in order to improve education..
    Objectives
    This study aimed to determine the relationship between learning styles preferences and gender, educational major and status in first year students at Isfahan University of Medical Sciences..Patients and
    Methods
    A cross-sectional study employing the visual-aural-read/write-kinesthetic (VARK) learning style’s questionnaire was done on 184 first year students of medicine, pharmacy, dentistry, nursing and health services management at Isfahan University of Medical Sciences in 2012. The validity of the questionnaire was assessed through experts’ views and reliability was calculated using Cronbach’s alpha coefficients (α = 0.86). Data were analyzed using the SPSS ver.18 software and x2 test..
    Results
    Out of 184 participants who responded to and returned the questionnaire, 122 (66.3%) were female; more than two-thirds (68.5%) of the enrolled students were at the professional doctorate level (medicine, pharmacy, dentistry) and 31.5% at the undergraduate level (nursing and health services management). Eighty-nine (48.4%) students preferred a single-modal learning style. In contrast, the remaining 95 students (51.6%) preferred multi-modal learning styles. A significant relationship between gender and single modal learning styles (P = 0.009) and between status and learning styles (P = 0.04) was observed..
    Conclusions
    According to the results, male students preferred to use the kinesthetic learning style more than females, while, female students preferred the aural learning style. Knowledge about the learning styles of students at educational institutes is valuable and helps solve learning problems among students, and allows students to become better learners..
    Keywords: Medical Students, Learning Style, VARK, Survey
  • Ehsan Taheri, Ahmad Ghorbani, Maryam Salehi, Hamid Reza Sadeghnia * Page 15
    Background
    Tobacco consumption is the second major cause of death and the fourth most common risk factor for diseases, worldwide. Epidemiologic studies have traced the use of alcohol, tobacco, and illicit substances among medical students and physicians..
    Objectives
    The current study aimed to investigate the prevalence of cigarette smoking and the related factors among the students of medical sciences in Mashhad University of Medical Sciences, Mashhad, Iran..Patients and
    Methods
    This cross-sectional study was conducted on 946 health professional students in Mashhad University of Medical Sciences (MUMS, Iran) in autumn 2008. A standard self-administered questionnaire consisting of socio-demographic data, participant smoking status, family and peer smoking, attitudes and beliefs about smoking, awareness of cigarette negative effects and reasons for smoking cessation was used in the current study..
    Results
    Among the students, 18.3% reported having ever tried or experienced with cigarette smoking. The overall prevalence of cigarette smoking was 9.8% with significant differences in prevalence rates by gender, 17.6% among males and 4.2% among females. Starting and continuing smoking was significantly correlated with the family cigarette consumption habits. The most common reason to start smoking was friends (24.9%) and the most important reason to continue smoking was personal life distress (17.6%). The majority of participants (92.3%) reported that they were aware of the hazards of smoking. A significant difference regarding awareness of smoking hazards was observed between smokers and non-smokers. The most important preventive factor for cigarette smoking was religious beliefs (69.1%)..
    Conclusions
    Although the prevalence of regular smokers among health professions students of MUMS was lower than general populations, but this level is still alarming and points at the rapid growth of cigarette use, especially among female students. Medical schools should work harder to tackle this phenomenon and address it more efficiently in their curricula..
    Keywords: Cigarette, Health, Smoking, Students
  • Hassan Ziaaddini, Ahmad Ziaaddini *, Neda Asghari, Nozar Nakhaee, Mahin Eslami Page 16
    Background
    Substance abuse or drug addiction is one of the most important health issues in every society, which can lead to physical and mental problems..
    Objectives
    This study aimed to compare the efficacy of tramadol plus gabapentin versus methadone use in the treatment of opiate withdrawal..Patients and
    Methods
    Consenting male subjects who fulfilled the DSM-4 criteria for opiate dependence syndrome (opium, residue, and heroin) were randomly assigned in two groups to receive tramadol plus gabapentin or methadone. Assessment tools were Adjective Rating Scale for Withdrawal (ARSW), Clinical Opiate Withdrawal Scale (COWS) and Visual Analogue craving Scale (VAS). Fifty-nine subjects were enrolled and evaluated on days 1, 2, 3, 4, 6, and 8 during their 10 days of admission. Twenty-nine participants received methadone and the other 30 received tramadol plus gabapentin for their treatment..
    Results
    Mean (SD) age of the patients in methadone group and tramadol plus gabapentin group were 33.9 (7.1) and 32.4. (8.1), respectively (P = 0.462). The overall ARSW (P value = 0.263) and COWS (P = 0.862) scores between the two groups were comparable. The differences in the VAS score for craving between the two groups was marginally significant (P = 0.057). The highest VAS score was at the third day of admission in both groups and it was generally higher in methadone group..
    Conclusions
    The severity of withdrawal syndrome in two groups was not significantly different. The craving was higher in the group receiving methadone from the second day of admission even though the usage amount was higher in the tramadol plus gabapentin group. The findings of this study suggest that the combination of tramadol plus gabapentin is an efficient method for opioid detoxification..
    Keywords: Tramadol, Methadone, Randomized Controlled Trial, Humans, Opioid
  • Hadi Zare Marzouni, Zohreh Lavasani, Minoo Shalilian, Reza Najibpour, Masoud Saadat Fakhr, Reza Nazarzadeh, Ali Farshad, Nosrat Bahrami * Page 17
    Background
    Over one million new cases of breast cancer (BC) are diagnosed each year with a mortality rate of more than 600 thousand women per year. Breast self-examination (BSE) is a patient-centered, inexpensive, and noninvasive diagnostic test. We focused on the role of screening in BC in early diagnosis..
    Objectives
    The purpose of this study was to evaluate awareness and attitude of women toward BSE in Dezful City, Iran, in 2013..Patients and
    Methods
    This descriptive cross-sectional study included 1020 women over 15 years of age in Dezful City, in 2013. Simple random clustering was used to enroll accessible women. We have applied the available pieces of software for statistical analysis..
    Results
    The mean age of recruited women was 37.1 ± 1.3 and 23.6% of participants had a history of BC in themselves or in their relatives (mother, sister, aunt, and grandmother). In addition, 70.1% of participants benefited from early diagnosis of BC, 83.3% of participants considered BSE necessary and useful for early diagnosis of BC, and 51% of them performed BSE. There was a statistically significant correlation between being married and doing BSE (P = 0.034) and between women‘s level of education and awareness to perform BSE (P = 0.009)..
    Conclusions
    With regard to high prevalence of BC in Iran, this study showed a positive attitude of women in Dezful City toward BSE. Health policymakers in Dezful City can establish training programs to increase women’s awareness of BSE and to instruct them to perform it properly..
    Keywords: Breast Cancer, Self, Examination, Awareness, Attitude
  • Abbas Ali Jafari, Abbas Falah Tafti *, Seyed Mehdi Hoseiny, Abdolhossein Kazemi Page 18
    Background
    Adherence and colonization of Candida species particularly C. albicans on denture surfaces, forms a microbial biofilm, which may result denture stomatitis in complete denture users..
    Objectives
    The purpose of the present study was to evaluate the antifungal effect Zataria multiflora essence in removing of Candida albicans biofilms on experimentally contaminated resin acryl plates..
    Materials And Methods
    In the present experimental study, 160 resin acrylic plates (10 × 10 × 1 mm) were contaminated by immersion in 1 × 103 C. albicans suspension for 24 hours to prepare experimental Candida biofilms. The total number of Candida cells, which adhered to 20 randomly selected acryl resin plates was determined as the Candia load before cleaning. The remaining 140 plates were divided to seven groups of 20 and immersed in five concentrations of Zataria multiflora essence from 50 to 3.125 mg/mL as test, 100000 IU nystatin as the positive and sterile physiologic serum as the negative control. The remaining Candida cells on each acryl plate were also enumerated and data were analyzed using the SPSS 16 software with Kruskal-Wallis and Wilcoxon tests..
    Results
    Zataria essence at concentrations of 50 and 25 mg/mL removed 100% of attached Candida cells similar to nystatine (MFC), while weaker Zataria essence solutions cleaned 88%, 60.5% and 44.7% of attached Candida cells. Kruskal-wallis test showed a statistically significant difference between all test groups (P = 0.0001). In this study 12.5 mg/mL concentration of Zataria multiflora was considered as the minimum inhibitory concentration (MIC90)..
    Conclusions
    Zataria essence, at concentrations of 50 and 25 mg/mL, effectively removed Candida cells that had adhered to the denture surface, similar to the level of removal observed for 100000 IU nystatin..
    Keywords: Disinfection, Candida albicans, Acrylic Resins, multiflorol
  • Aminreza Tabatabaei, Abbas Heidarzadeh, Navvab Shamspour *, Pirhosein Kolivand Page 19
    Background

    Diagnosis and treatment of respiratory tract infections (RTI) in a mass-gathering situation such as hajj is a medical challenge that requires quick decision-making and considerable knowledge about its etiology and treatment methods. High prevalence of RTI during Hajj and tendency of caravan physicians to treat of patients quickly in such situation lead to prescription of parenteral steroids. Nonetheless, no study has focused on the short-term and long-term effects of systemic steroids in Hajj pilgrims with RTI..

    Objectives

    This study focuses on efficacy of systemic consumption of corticosteroids in alleviating symptoms of RTI..Patients and

    Methods

    This clinical trial was included 1671 pilgrims in Hajj 2012 who had symptoms of RTI based on caravan physician’s findings. The patients were divided to two groups to receive either parenteral corticosteroid or other drugs. Patients who received antibiotics for bacterial infections were excluded. This survey concentrated on general symptoms of RTI during Hajj such as fever, musculoskeletal pain, coryza, sore throat, cough, dyspnea, and hoarseness before, 24 hours after, and five days after drug consumption. For classification and analysis of data, SPSS 17 was used. Descriptive statistical and Chi square test were used to compare variables..

    Results

    In comparison to corticosteroid injection, treatment without systemic corticosteroids could reduce the fever more significantly within five days (P < 0.05), while it had no effect after 48 hours (P > 0.05). Although corticosteroids alleviated the symptoms during the first 48 hours (P > 0.05), they had no more effect after five days of consumption (P > 0.05). Treatment with medications other than corticosteroid had less effect on reducing coryza (P > 0.05) while corticosteroids had significant alleviating effect on coryza, cough, and musculoskeletal pain (P < 0.05)..

    Conclusions

    There is a need to conduct more comprehensive studies on effect of combination therapy with corticosteroids and antibiotics as well as their short-term and long-term adverse effects on the immune system. While injecting corticosteroids is commonly administered in patients with RTI, they are not recommended due to the lack of data on their long-term therapeutic and adverse effects..

    Keywords: Corticosteroids, Fever, Hoarseness, Cough
  • Mehrdad Salehi, Hooman Kharaz Tavakol, Maede Shabani, Tayebe Ziaei * Page 20
    Background
    Self-esteem is the value that the individuals give themselves, and sexual self-concept is also a part of individuality or sexual-self. Impairment or disability exists not only in the physical body of disabled people but also in their attitudes. Negative attitudes affect the mental health of disabled people, causing them to have lower self-esteem..
    Objectives
    This study aimed to examine the relationship between self-esteem and sexual self-concept in people with physical-motor disabilities..Patients and
    Methods
    This cross-sectional study was conducted on 200 random samples with physical-motor disabilities covered by Isfahan Welfare Organization in 2013. Data collection instruments were the Persian Eysenck self-esteem questionnaire, and five domains (sexual anxiety, sexual self-efficacy, sexual self-esteem, sexual fear and sexual depression) of the Persian multidimensional sexual self-concept questionnaire. Because of incomplete filling of the questionnaires, the data of 183 people were analyzed by the SPSS 16.0 software. Data were analyzed using the t-test, Man-Whitney and Kruskal-Wallis tests and Spearman correlation coefficient..
    Results
    The mean age was 36.88 ± 8.94 years for women and 37.80 ± 10.13 for men. The mean scores of self-esteem among women and men were 15.80 ± 3.08 and 16.2 ± 2.90, respectively and there was no statistically significance difference. Comparison of the mean scores of sexual anxiety, sexual self-efficacy, sexual self-esteem, sexual fear and sexual depression among men and women showed that women scored higher than men in all domains. This difference was statistically significant in other domains except the sexual self-esteem (14.92 ± 3.61 vs. 13.56 ± 4.52) (P < 0.05). The Kruskal-Wallis test showed that except for sexual anxiety and sexual self-esteem, there was a statistical difference between other domains of people’s sexual self-concept and degree of disability (P < 0.05). Moreover, Spearman coefficient showed that there was only a correlation between men’s sexual anxiety, sexual self-esteem and sexual self-efficacy with their self-esteem. This correlation was positive in sexual anxiety and negative in two other domains..
    Conclusions
    Lack of difference in self-esteem of disabled people in different degrees of disability and in both men and women suggests that disabled people should not be presumed to have low self-esteem, and their different aspects of life should be attended to, just like others. Furthermore, studies should be designed and implemented based on psychological, social and environmental factors that can help disabled people to promote their positive sexual self-concept through marriage, and reduce their negative self-concept..
    Keywords: Self, Esteem, Physically Disabled, Sexual Self, Concept