فهرست مطالب

فصلنامه دانشگاه علوم پزشکی و خدمات بهداشتی درمانی زابل
سال هفتم شماره 2 (تابستان 1394)

  • تاریخ انتشار: 1394/06/30
  • تعداد عناوین: 7
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  • Ali Rashki Ghaleno, Zohre Mahmoodi, Mahlagha Sargolzaee * Page 1
    Background
    Given the prevalence of thalassemia in our country, especially in the province of Sistan and Baluchestan and considering that cardiac complication due to iron overload is the main cause of death in these patients, we decided to assessment cardiac complications in patients with thalassemia in Zabol. It should be noted that a similar study was not done before in this area.
    Materials And Methods
    This study was conducted with analytic method. The sample size was whole thalassemia major in Zabol (until 1391) that the rate was 100. Variables studied included age, age at onset chelators, serum ferritin levels, parental education level, blood groupe, gender and residence of patients. Information of the study is performed by echocardiography and electrocardiography by a cardiologist and also data were collected from patients'' files and were analyzed by statistical software spss.
    Results
    The total 100 patients, 93% had echocardiographic cardiac complications and 83%had abnormal findings of electrocardiographic. Most of the echocardiographic findings were, valvular disorders to the extent of 89% and then systolic dysfunction (63%), cardiomegaly (43%), pulmonary hypertension (P.HTN) (21%), diastolic dysfunction (12%) and pericardial effusion (3%). Most of electrocardiographic findings was Inverted T waves as much as 42%. Thirty seven patients were male and 63 patients were female. 45% of patients live in urban areas and 55% in rural areas. The mean age of patients was 15.38 years and 54% of patients were aged 10 to 20 years. The Mean age of beginning chelators (deferoxamine) was 8.9 years. The mean serum ferritin level was 5575.56 ng/ ml. Most parents were illiterate and blood group of patients was (48 %) O.
    Conclusions
    Based on chi-square tests, significant relationship (P <0.05) was found between age, age of onset of deferoxamine, father''s educational level, female gender and blood group with cardiac complications. However no significant relation was found between serum ferritin level, mother''s education level and location with cardiac complications. it is recommended to act in order to train low literacy parents and raising awareness among parents and patients about heart complications and raising awareness among parents and patients about heart complications and the importance of early and appropriate treatment with deferoxamine blood and so it is recommended to evaluate patients with thalassemia for effects of cardiac complications at an early age and further studies in association with examined the relationship of blood group and gender of patients with cardiac complications.
    Keywords: beta, thalasemia, cardiac complication
  • Mehdi Safari Bak, Mostafa Payandeh, Milad Ameli, Mohsen Damavandi, Ahamd Ebrahimi Atri, Nahid Khoshraftar Yazdi* Page 2
    Introduction
    Considering to the anatomical structure of the foot and position it at the bottom of the chain mobility of the lower extremities and also relied on a relatively small area on the body maintains its balance, it seems that smallest changes biomechanical in level of support affect on postural control. The aim of the present study was to investigate the dynamic and semidynamic individuals who have a flat foot.
    Materials And Methods
    In this study, of the 86 children with flexible flat foot, 15 subject with a mean age (10.06 ± 0.45), Height (123.30 ± 8.24) and Weight (26.25 ± 4.98) Were targeted to non-random. The control group included 15 children with normal feet that of terms of anthropometric indices were homogeneous with flat foot groups, were targeted to non-random. dynamic balance with the Star Excursion Balance Test and semidynamic balance was measured with the Biodex Stability System.
    Results
    The results showed that subject with flat foot in semidynamic balance in direction of anterior - posterior (P < 0.01) and also in dynamic balance in direction anterior (P < 0.0001), posterior (P < 0.02) and internal anterior (P < 0.000) are significantly different between the two groups.
    Conclusions
    According to the results of this study It seems, flat foot more is effective on balance anterior - posterior. This could be due to disruption of the posterior - anterior forces distribution exerted on the foot, Due to muscle weakness, especially Tibialis Posterior muscle weakness and subsequent stretching of the calcaneonavicular ligament that Responsible force distribution in the anterior and Posterior part of the foot.
    Keywords: flat foot, semidynamic balance, dynamic balance, star excursion balance test, biodex stability system
  • Seyed Reza Mazlom, Ebrahim Khaleghi, Fatemeh Heshmati Nabavi, Elham Shahraki Moghaddam, Zahrasadat Manzari* Page 3
    Aims
    The unstable condition of clinical situation of patients in Intensive Care Unit; is require that nurses’ be competent in decision making. The case-based learning is one of the novel educational methods that can lead to development clinical decision making. This study was conducted to determine the effect of two methods of case-based learning and lecture on nurses clinical decision making skill in intansive care unit.
    Materials And Methods
    In this experimental study pre test and post test method, Shahid Kamyab and Imam Reza Hospitals in Mashhad were assigned into two groups: case-based learning and lecture group. Then through randomization, 60 ICU nurses’ were selected. In Case-based learning group to education of nurses’ was used of reality-based scenarios and and in the traditional group of lecture. Both groups completed a clinical decision making questionnaire before and fourty five days after the intervention. Data analysis was done with using ttest, paired t-test, Mann-Whitney and Chi-Square in SPSS V.16 at the significant level 0.05.
    Results
    There was no significant difference in nurses’ decision making (P = 0.162) between the tow groups before the intervention; but significant differences were seen in both groups after the intervention (p = 0.02). In the mean difference pre and post-test in the case-based learning group (35.5 ± 28.2) than lecture group (13.4 ± 7.2) were seen significant differences (P < 0.001).
    Conclusions
    The results showed that educational method of case-based learning will be more effective in the development of clinical decision making of nurses rather than lecture. Therefore, it is recommended that this educational method be used in service training programs to improve nurses decision making skills.
    Keywords: case based learning, lecture, clinical decision making, intensive care unit
  • Zahra Rashki Ghalehnoo, Abbas Ganjali * Page 4
    Introduction
    Pseudomonas aeruginosa has a major role in development of nosocomial infections. Infections caused by P.aeruginosa and dissemination of metallo-beta-lactamases (MBL) have been reported with increasing frequency through-out the world.The aim of this study was to investigate the antibiotic susceptibility and identification of blaIMP-1, blaVIM-1 and blaSPM-1 in P. aeruginosa isolates collected from clinical samples in Zabol, Iran.
    Materials And Methods
    In this cross-sectional study, 527 clinical samples were cultured and P. aeruginosa isolates was identified by conventional biochemical test. The antimicrobial susceptibility was tested by disk diffusion (Kirby-Bauer) method and MBL producing strains were identified by double-disk synergy test (DDST). From genotypical point of view the presence of blaIMP-1, blaVIM-1 and blaSPM-1 genes was confirmed by PCRusing specific primers.
    Results
    Of 527 clinical samples, 160 isolates (30%) were identified as P. aeruginosa. The resistance rates: imipenem, ciprofloxacin, ceftazidime, cefixime, tobramycin, piperacillin and polymyxin Bwere 14%, 9%, 19%, 98%, 4%, 13% and 13% respectively.DDS test showed that of 22 resistant isolates to imipenem 10 (45%) were MBL producing. We found 10 MBL producing strains by PCR, 100% had VIM gene, 80% carried IMP gene and 80% had both VIM and IMP genes. None of the isolates hadSPM gene.
    Conclusions
    The results showed that, in contrary to the results of studies conducted in other parts of Iran˒ MBL producing isolates had the declining trend in studied area and the frequency of VIM gene is higher than IMP gene.
    Keywords: Pseudomonas aeruginosa, Metallo, Beta, Lactamases (MBL) Enzymes, Antibiotic Resistance
  • Shahrokh Navidpour, Mohammad Hossein Razi Jalali, Alireza Alborzi, Fatemeh Boron, Hossein Hamidinejat* Page 5
    Introduction
    Shadegan wetland is a suitable ecology for Anopheles activity. Anopheles mosquitoes are important vectors of plasmodium species, filariasis and causing agents of encephalitis. Studies have shown that at least 7 species which are important in malaria transmission are present in Iran. From these species An. maculipenis is more distributed in southern Iran than other species.
    Materials And Methods
    In the present study which performed in the spring, autumn and winter 2009 and 2013, from 5 different zones around the Shadegan wetland, 3884 mosquitoes were gathered with sucking tube and New Jersey trap and diagnosed according to the diagnostic keys.
    Results
    From trapped mosquitos 440 of them were Anopheles spp. which 330 (75%) were An. pulcherimus, 82 (18/63%) An. hyrancus, 22 (5%) An. stephenci and 6 (1/36%) An. turkhudi
    Conclusions
    An. stephenci has been reported as a vector of malaria in Iran. Such studies need further attempts for understanding the distribution of mosquitoes and infectious agents and also case reports of related diseases.
    Keywords: Anopheles, Malaria, Shadegan wetland, fauna
  • Mahmood Anbari, Azita Shahraki Mohammadi * Page 6
    Introduction
    One of the most important branches of scientometrics is citation analysis which offers patterns showing authors’ information searching behavior and authors’ authorship. Citation Analysis provides a pattern of authors’ Information-seeking behavior and also content analysis provides a pattern of authorship. This study aimed to citation analysis of article published in the Quarterly Journal of Zabol University of Medical Science from 2010 to 2014.
    Materials And Methods
    In this descriptive study, the citation and content of 211 published articles in the ZBMU during 2006 - 2011 were analyzed. Data analysis was performed by SPSS version 20 and Excel 2013, and descriptive and inferential statistical methods were applied SPSS20 and Excel 2013 using descriptive statistical methods.
    Results
    Out of 4099 citations in 118 published articles from the view point of citations to the type, the shape and the language of the resources, the maximum were for journals 3412 citations, print material (98.26%) and English language (73.36%). The mean of citations for each article was 34.7. Out of 118 authors most of them were male (70.34%), most of corresponding authors were M.Sc. (36.96%) and most of them were affiliated to ZBMU (36 tittles). Most of them were written by more than one author 116 title (98.30%). The mean half-life Persian sources of 6 years and two months and Latin Resources is 9 years and two months.
    Conclusions
    Although published articles in Quarterly Journal of Zabol University of Medical Science have had an acceptable condition from the view point of authorship pattern, considering limited usage of up-to-date and electronic resources, it seems to have taken measures to improve the information-seeking behavior and encourage authors to use these resources to be more effort.
    Keywords: Citation Analysis, Bibliometrics, Content Analysis, Journal of Zabol Universityof medical science
  • Majid Mojarad, Javad Akhondian, Zohre Kiani, Kazem Hasanpour, Farah Ashrafzadeh, Mehran Beiraghi Toosi, Mohammad Hasan Mohammadi* Page 7
    Ataxia telangiectasia (AT) is an autosomal recessive genetic disease, which mainly effects the nervous and immune system. Disease onset is between the age of 1 and 4 years. The usual presentation is a neurodegenerative disorder, with progressive cerebellar ataxia, ocular or cutaneous telangiectasia along with recurrent infections and high cancer incidence. AT patients has sensitivity to ionizing radiation. Here we present a 10 years old girl with a presentation which leaded us to the diagnosis of ataxia telangiectasia.
    Keywords: Ataxia telangiectasia, nervous system destruction