فصلنامه یافته
سال هفدهم شماره 2 (پیاپی 62، تابستان 1394)

Authorizing abortion in some cases of fetal and maternal diseases which was implemented by passing its law in 2005, a major change in therapeutic abortion was performed in Iran,s health system. Although there may be cases of illegal abortion, but our study examined legal abortion of Lorestan province in 2013, which led to increase in awareness of health professionals about indications of therapeutic abortion, the time to do it and answer to related questions. In this epidemiological and cross-sectional study, all applications for abortion permission, received by Lorestan legal organization in 2013, were studied. The data were recorded in a questionnaire and analyzed using SPSS software. From 205 cases during a year, 144 of them obtained permission for abortion of which 88% issued for fetal abnormalities and 12% due to illness of the mother. The most common diseases in the fetus were, the brain and skull abnormalities, and in the mothers, cardiovascular diseases and hematologic abnormalities were the highest. In these cases, the most frequency belonged to the age group of 25-34 years. For 61 requests, permission for abortion had not been issued. High gestational age (26 cases) and diseases of the brain and skull, were the most common reasons of request for abortion. Abortion means therapeutic abortion and with the increase in the authorized therapeutic abortion, the illegal abortion will be reduced and leads to increase in the health of pregnant women. By increasing awareness of the medical staff about permitted therapeutic abortion and related laws, a correct and better guidance of pregnant women, we can help them to have a healthy community. As well as the problems of obstetricians and gynecologists, in this field, will be decreased.

Elderly is a worldwide problem which at a near future will be considered as one of the most important social and welfare challenges in developing countries. Therefore in this research social support and life satisfaction of the elderly resident in sanatorium compared with those living with family. This analytic-epidemiologic study carried out on 120 male and female elders (60 in sanatorium and 60 in home) selected by systematic and cluster random method. For measuring life satisfaction, Life Satisfaction Questionnaire (LSQ) (with reliability 0.89) and for social support, Social Support and Stress Scale (SSSS) were used. Data were analyzed using correlation and U Mann-Whitney by SPSS 20 software. The results showed a positive and significant correlation (r=0.746, p<0.05) between social support and life satisfaction and stress had the revers and significant relation (r=-0.383, p<0.05) with life satisfaction. Also results showed that indexes of life satisfaction, stress and social support have a significant different in elders resting in sanatorium and family (p<0/05). Based on the results, social support and coping with stress especially family stress cause increasing life satisfaction level in elders.

Despite of extensive global control programs of tuberculosis, the prevalence of this disease in underdeveloped and developing countries still remains high.Also the prevalence of latent TB infection in hospital staff has a particular importance. In a descriptive-analytic study conducted from March to June 2015 in Khorramabad Ashayer hospital on employees, after taking history and consent of the employees, a Tuberculin Skin Test (TST) was conducted and the results were read 72-48 hours later. Also to study booster effect in patients with negative TST, test was repeated one week later. The criteria for diagnosis of latent tuberculosis was tuberculin test with induration greater than 10 mm. Totally of 160 women (7.71%) and 63 men (28/3%) with a mean age of 32.07 years old participated in this study. From 223 participants, 177 (71.7%) had indurations less than 5mm, 11 (4.9%) had indurations between 5-10mm, 20 (9%) had indurations between 10-15mm and 9 (9%) had indurations more than 15mm. In this study, among the sex, age, duration of employment, history of contact with TB patients and latent TB no significant relationship was found, but there was a significant relationship among the job, activities unit and latent TB. In this study, from 223 participants, 40 (18%) were infected with latent TB, which according to the number of positive smear patients admitted to this hospital represents a serious need for more comprehensive educational programs and prompt actions to prevent this infection.

Since only the correct and effective Cardiopulmonary Resuscitation (CPR) can increase the survival of patients with cardiopulmonary arrest, the aim of this study is to determine the effects of CPR training in the anesthetioligy ward to improve CPR knowledge and clinical skills of interns of Lorestan university of medical sciences. A 10-month Educational experimental study was done on 31 undergraduate medical students at Lorestan university of medical sciences in 2013. During a period of 15 days of anesthesiology internship course, all these students underwent CPR training including Basic Life Support (BLS), Advanced Cardiac Life Support (ACLS) and practical skills. Data were collected via a questionnaire with 4 parts including demographic, pre and post knowledge and skills as standpoint of interns and ward,s professor. After training the mean of score about knowledge of CPR and its practical skills significantly increased from 5.68 to 7.94 and 10.65 to 23.45 respectivly (PV=0.0001). A significant relationship between preinternship exam score and knowledge of CPR before anesthesiology internship course was shown (PV=0.001), but there was no significant relationship with practical skills score pre and post CPR training in anesthesilogy ward.(PV=0.38) The CPR training course in anesthetiology ward leads to significant increase in CPR skills and Knowledge of medical interns. Adding this course to undergraduated medical students is essential.

Chronic Cerebral Hypoperfusion (CCH) is a common pathophysiological state that generally happens in conditions such as Alzheimer and vascular dementia, which both of them are known by cognitive impairment. The recognition of particular mechanisms in the chain of events from CCH to a cognitive deficit may identify potential targets for efficient therapies. The purpose of this study was to examine the effects of olive leaf extract, with regarding the antioxidant and antiinflammation effects of extract, on corticostreon and dehyroepiandrestrone (DHEA) after the induction of cerebral hypoperfusion in rats. Wistar rats were divided into five groups of control, hypoperfusion, (hypoperfusion + 100 mg/kg extract), (hypoperfusion +200mg/kg) and (hypoperfusion + 300mg/kg).In the hypoperfusion groups both common carotids were permanently occluded (with one week interval). Surgery without occlusion of the carotid was applied on the control. Olive leaf extracts with dosages 100, 200 and 300 mg/kg was given to the animals by gavage technique for 25 days. Then blood samples were taken and the serum concentration of corticostrone and DHEA were measured by ELISA method. In comparison with the control group, there was a significant reduction in corticostrone concentration in hypoperfusion group but olive leaf extract with 300mg/kg dosage, succeeded in abolishing the reduction. The significant differences in DHEA concentration was not observed among treated groups. In this study, the olive leaf extract succeeded in elevating of corticostrone concentration which was reduced by hypopefusion, this study showed the protective effects of olive leaf extracts on hypothalamus – hypophysis –adrenal axis, since the extract has wide useful effects, we suggest it’s effective components to be separately examined to find the exact mechanism.

Neuropathy is an important complication and contributes to the morbidity of diabetes mellitus. Evidence indicates early detection of neuropathy results in fewer foot ulcers and amputations. The purpose of this study was to evaluate the prevalence of peripheral neuropathy in diabetic patients. Methods and Materials: This cross-sectional study was conducted on diabetics selected randomly from those who referred to diabetes center of Khorramabad in 2015. The data collecting sheet included demographic information, body mass index and Michigan questionnaire which consisted of two parts. The first part assessed neuropathic symptoms and the second part encluded a brief physical examination. The descriptive and analytic statistics were used for data analysis. The prevalence of diabetic neuropathy in patients was 28 percent. duration of disease was signifcantly associated with DPN ((P value <0.05).We observed no association between neuropathy and other variabls. The results of this study emphasize the importance of screening for early detection of neuropathy in diabetic patients. Michigan questionnaire would appear to be an appropriate, cheap applicability and easy to use tool for identifying patients at risk of having neuropathy.

Surgery is the most important treatment in gastric cancer (GC) patients and also chemotherapy and radiotherapy are used as adjuvant and/or neo-adjuvant therapies for reducing locally relapse and metastasis. This study aimed to compare patient's survival and affected factors in this two treatment groups. This historical cohort study was conducted on 181 patients underwent chemotherapy (group 1) and 201 patients underwent surgery (group 2). The effect of demographic, clinical and pathological risk factors on patient's survival was assessed by log-rank test and Cox Proportional Hazard (CPH) model. Data were analyzed using SPSS16. Fifty and six patients (30.6%) in surgery group and 69 patients (34.3%) in chemotherapy group passed atoay death by the end of the study. The median survival time in two groups was 19 and 28 months, respectively. Age at diagnosis and tumor grade in surgery group, and gender and pathologic stage in chemotherapy group were significant (p<0.05). Demographic and pathological characteristics of patients are the significant determinant of treatment success and increasing survival, however, assessing the causal effect of treatments on survival will be well achieved via controlled clinical trials through which the effects of confounders can be controlled.

Osteoporosis is a major public health priority in Iran and the world. Recently, prevention of osteoporosis has become the goal of many health professionals. Behavior change is one of the most powerful strategies for osteoporosis prevention. This study aimed to determine the predictors of osteoporosis prevention behavior in women aged 30-50 in Khorramabad. This descriptive-inferential cross-sectional study included 269 women aged 30-50 selected from all the health centers of Khorramabad according to the inclusion criteria of the study and through cluster and systematic sampling method. Data gathering tools were valid and reliable questionnaires of demographic information, stages of change, decisional balance, self-efficacy, and physical activity. Chi-square test, Spearman correlation coefficient, and logistic regression were applied to analyze the data. The mean age of the subjects was 38.72±7.003, and the mean light weekly physical activity was 38.83±56.400. The results also showed that the construct of self-efficacy had the highest predictive power of preventive behavior. The results showed that self-efficacy among the constructs of the Trans-theoretical Model was the only predictive construct for osteoporosis prevention behavior. Therefore, the findings of this study can serve as a base for educational interventions in behavioral changes to prevent osteoporosis by health authorities.

Psychostimulant amphetamine (Ecstasy and Crystal meth or n-methyl-1- phenyl-propan-2- amine) abuse has been prevalent among the youth of Iran in recant years. These substances have many adverse and destructive effects on several organs. Therefore, this study was done to determine the effect of crystal meth on pituitary-gonadal axis in adult male rats.

28 male adult rats were divided into four groups; normal control group, and 5, 10 and 15 mg/kg bw Crystal meth-treatment groups. Animals in the Crystal meth-treated groups received 5, 10 and 15 mg/kg bw of Crystal meth intraperitoneally for seven days. After 7 days, blood sample was taken from the left ventricle of the animal's heart and LH, FSH and testosterone concentration were measured using ELISA kit. The SPSS-16 statistical software was used to analyze data. All data were analyzed by one-way analysis of variance (ANOVA) and the differences were considered significant at the p<0.05 level.

Testosterone hormone concentration significantly increased in experimental groups (10 and 15 mg/kg bw) in comparison with control group (P<0.05). Concentrations of FSH and LH in the experimental groups (5, 10 and 15 mg/kg bw) significantly reduced in comparison with control group (P<0.05).

According to the hormonal examinations, we concluded that the use of Crystal meth causes destructive effects on the male pituitary-gonadal axis. Keywords:

With regard to the importance of attachment in developing separation anxiety, the purpose of this study was to investigate the effectiveness of attachment based intervention via video feedback on decreasing negative representations and separation anxiety problems in preschool children. The research method was semi experimental with pretest-posttest and follow up. For this, 21 mother-child dyads (11 dyads in experimental and 10 dyads in control group) were selected from 2 child counseling centers based on including criteria. The experimental group received 8 to 10 individual attachment based intervention sessions and the control group received the other relation based intervention for comparison of their effectiveness. The participants were assessed using maternal behavior Q-SORT, MacArthur story stems and child psychopathological symptoms inventory in pretest, post-test and 3 months interval follow up. The findings revealed the effectiveness of attachment-based intervention on increasing maternal sensitivity, decreasing negative representations of child and also separation anxiety symptoms in children of experimental group. The mean scores of experimental group in comparison to witness group have significantly decreased in all variables. Considering this results, it seems attachment-based intervention could increas maternal sensitivity and this change with decreasing negative representation of child via recovering interactions have a positive effect on decreasing separation anxiety problems of children.

The Alzheimer is a common progressive and degenerative disease which causes dementia and ruin of brain cells especially in Hippocampus region. Recently, it has been appeared that Erythropoietin with its neural-protective action causes an improvement in cognitive functions during this disease. This study aims to find an alternative approach instead of traditional intraventricular injection to deliver Erythropoietin into the brain without passing the blood-brain barrier. In order to induce Alzheimer in rats, the STZ was injected in lateral ventricles of brain. Two weeks after Alzheimer induction, different doses of erythropoietin were injected in sisternamagna for treatment of the disease with decreased side effects. After the treatment period, all rats were tested by passive avoidence learning test using shuttle box, and measuring of blood hematocrit. Although the Erythropoietin did not have significant influence on improvement of memory and learning phenomena in both control and sham groups, it resulted in a significant difference in improvement of the disease comparing STZ group that this treatment was accompanied with decreased hematocrit than the group receiving 5000 U/Kg doses. These results suggested that injection of STZ in lateral ventricles of brain contributes to extreme damage in memory and learning similar to Alzheimer; on the other hand, Erythropoietin prevents such a damage accompanied with decreased hematocrit.

Toxoplasmosis with a worldwide distribution is one of the most common opportunistic infections in the immunodeficient patients and causes abortion and congenital complications in pregnant women infected with acute infection. The main route of infection is contact with infected cat and consuming under-cooked meat. Because the presence of parasite in the all body fluids, it is probable that transfusion during acute infection leads to transmission of the parasite. The aim of this study was to evaluate the IgM and IgG antibodies in the Hamadan blood donors and its relation to some epidemiologic risk factors.

In this cross-sectional study, a total of 540 blood specimens were taken randomly from healthy blood donors in the Hamadan blood transfusion center. All samples examined by ELISA method for IgG and IgM antibodies. The results analyzed in relation to epidemiological factors such as age, gender, occupation and some Toxoplasma infection risk factors.

About 518 participants in this study were male, others were female. Totally, 294 (54.4%) of studied population were positive for IgG antibody and 10 (1.9%) were positive for IgM antibody. There was no significant relationship between seropositivity and Toxoplasma infection risk factor.

Because the screening didn’t perform on the blood donors in Hamadan; according to results of this study, Toxoplasma infection in blood donors of Hamadan is relatively high and, the rate of IgM antibody could considered for screening of this population.