فهرست مطالب بهجت مرزبانی

World Health Organization recommends and supports studies about leishmaniasis as one of the six major tropical and subtropical diseases. Iran is one of countries with relatively high infection rate of cutaneous leishmaniasis, so, the purpose of this study was to investigate the epidemiological status of cutaneous leishmaniasis in Kermanshah province, western Iran.

In a cross-sectional study, we investigated the records of all patients with leishmaniasis positive smears between 2011 and 2019 in Kermanshah province. Annual rate of the disease was calculated according to the data obtained from Statistical Center of Iran.

There were 1946 patients with leishmaniasis, including 1477(75.9%) men. The prevalence of leishmaniasis in Kermanshah province was 15.4 in 100,000 people. The prevalence of the disease in men and women was 23.4 and 7.42, respectively. Annual pattern of infection showed that in men the incidence rate was higher between November and January and lower in June, but no specific seasonal pattern was seen in women. The most common lesions were observed in hands and then the foot with an upward trend in recent years (P<0.001). But the trends for number of lesions in the head and body remained unchanged (P=0.7).

According to the seasonal pattern of cutaneous leishmaniasis especially in men and its relationship with their career, educational programs and trainings are recommended to prevent sandfly bites.

The aim of this study was to investigate the effect of self-care training for family health ambassadors on the number of doctor appointment for the treatment of minor ailments.

In this interventional study were surveyed 400 families. This study was performed in 2018-2019.The intervention group included families that had a health ambassador and the intervention was performed for health ambassadors. Data collection tool was a questionnaire designed by the Office of Education and Health Promotion of the Ministry of Health. Demographic information and the number of appointment to the doctor were also asked.According to the titles of the educational text and the family age groups, trainings were provided to health ambassadors once every 2 weeks for a year. Total of 24 training sessions were held by the health care providers of the selected health centers. The questionnaires were completed, one year after the intervention again.

Mean and standard deviation of test scores in the experimental group were upgraded before and after the intervention in the field of mothers and infants from 5 (± 2.9) to 22 (± 7.1), children from 5.7 (±1 4.1) to 19.6 (±6.6), adults and the elderly were from 2 (±1) to 9.4 (± 2.9) and adolescents from 2.1 (±1.80).Also, the number of appointments to the doctor due to minor illnesses decreased significantly in the intervention group during the year, so that from 888 appointments to the doctor by family members of trained health ambassadors before the intervention was reduced to 379 times after the intervention.(p<0.05).

Continuous self-care training along with following up and training family health ambassadors play an important role in increasing public awareness and reducing the number of unnecessary appointments to the doctor.
Keywords: Health ambassadors, Self-care, Minor ailments, Education, Reduce appointment to the doctor.

Background and Cardiovascular diseases are the leading cause of death in Iran and today these diseases occur at younger ages. The purpose of this study was to assess the effect of educational-based health promotion interventions using the Transtheoretical Model (TTM) on nutritional behaviors (consumption of fruits, vegetables, and fish) in order to reduce the risk factors for cardiovascular disease in high-risk adults.
We conducted a randomized controlled trial in 1230 people aged 30-50 years. Some information including the knowledge, food intake status (fruits, vegetables and fish consumption) and intermediate risk factors such as body mass index, abdominal obesity, blood pressure, blood lipids and blood glucose were recorded. Then 332 high risk participants (intervention group= 164 and control group= 168) were selected via multistage sampling. The interventions was carried out through training classes, brochures and posters, and text messages. Intervention programs were based on individuals’ readiness for behavioral changes.
Significant differences were found between the intervention and control groups in knowledge and consumption of fruits and vegetables (p According to this study, the model-based intervention was found effective in increasing health-oriented behavior. Increasing the intake of fish requires broader interventions and changes in anthropometric indexes and LDL demands more time.

Cardiovascular diseases (CVDs) are a major cause of death worldwide. The objective of this study was to determine the most important behavioral (inadequate nutrition, low physical activity, smoking and alcohol consumption) and non-behavioral (stress, high blood sugar, dyslipidemia, hypertension and obesity) risk factors for CVD among CVD patients hospitalized in Kermanshah Heart Hospital. This was a needs assessment study aiming at designing interventions for reducing CVD risk factors.
In this cross-sectional study 402 CAD patients (60.4% males and 39.6% females) were selected by consecutive sampling from among those hospitalized in Imam Ali Hospital for the first time. Data were collected using the Iranian version of WHO Stepwise questionnaire and the patients’ files and analyzed using the SPSS-16 software.
The mean (±SD) age of the patients was 54.2 (±8.8) years. About 73% of them had a poor diet and 46.5% had low physical activity; in addition, 36% of the men had consumed alcohol in the previous year and 26.1% were smokers. Non-behavioral risk factors were quite common too. The proportions of the patients suffering from diabetes, hypertension and overweight-plus-obesity and abdominal obesity were 49.3%, 48.0%, 54.7% and 61.0%, respectively. Finally, 43.3% of the patients had high stress, 31.0% were hypertriglyceridemic and in another 21% hypercholesterolemia was seen.
Based on the findings it can be concluded that, as compared to other risk factors, imbalanced nutrition was more prevalent common among the patients. Another major risk factor was obesity, particularly abdominal obesity. In addition, blood glucose disorders were more common than dyslipidemia.

The incidence of breast cancer in women is expected to rise sharply over the coming decades in Iran. The aim of this study was to determine risk factors for breast cancer in under-50-year-old women during the period 2013-2015 in Kermanshah, Iran.
This case-control study was carried out in Imam Reza Hospital and private clinics of oncologists (three clinics) in Kermanshah, Iran. The participants were 202 patients with breast cancer and 398 without breast cancer. Subjects of the experiment group were selected from among patients in the Departments of Oncology, Radiation Therapy, and Chemotherapy of the hospital, while the control group subjects were selected from among outpatients referred to specialty and subspecialty departments and private clinics of the hospital (outpatient, oncology, gynecology, ophthalmology, sonography, ENT, infertility). The two groups were matched for age. Data were collected by interviewing the subjects, the Gill standard questionnaire and the patients’ files and analyzed using the STATA software (version 12) ─ Odds Ratio (OR), 95% Confidence Interval (CI) and the Conditional logistic regression model.
The following variables were found to be the most important risk factors for breast cancer among under-50-Year-old women: a family history of breast cancer in second degree relatives, an age of 18-35 years at the first childbirth, and a history of a benign breast lump.
It is recommended to conduct further studies on the subject with due consideration of other risk factors for breast cancer, as well as education of women about breast self-examination and importance of periodic clinical examinations.