مجله دانشگاه علوم پزشکی بابل
سال نوزدهم شماره 3 (پیاپی 114، اسفند 1395)

In the medical world one of the most interaction between body and mind are related to coronary heart disease and it is a major cause of morbidity and mortality in the world. For this reason, identifying psychological risk factors in this context is necessary. In this regard, this study was performed with aimed to coping styles and quality of life in CHD patients and healthy individuals.
This study was a cross-sectional performed on 100 patients with coronary heart disease and 100 healthy subjects. Data was collected through Lazarus and Folkman coping styles questionnaires that included four problematic coping and four emotion-focused coping style and quality of life of the World Health Organization in four aspects of physical, psychological, environmental and social relationship with demographic characteristics were collected and compared.
FINDINGS: The mean of direct confrontive coping style in patients (8.75±2.81) were significantly more than healthy individuals (7.95±2.86) (p=0.036), the mean of escape-avoidance coping style in patients (9.80±4.59) were significantly more than healthy individuals (8.38±4.25) (p=0.045), and was not found significant difference between two groups in Problem-focused coping style, Also there was a significant difference in quality of life between two groups, in the physical health domain (p=0.000), psychological domain(p=0.001), social relationship domain (p=0.007) and environmental domain (p=0.003).
Result showed that the quality of life in CHD patients were lower than healthy individuals and CHD patients used direct confrontive coping style and escape-avoidance coping style, more than healthy individuals. Therefore this two styles can be considered as risk factors for CHD.

Lower extremity pain is an important cause of impaired physical activity and the incidence of disability in the elderly. Since vitamin D plays a role in bone metabolism, the present study aims to investigate the relationship between vitamin D deficiency and shinbone pain and sensitivity in the elderly.
This case-control study was conducted among patients who referred to the hospital because of nonspecific pain localized to the anterior surface of shin for 6 weeks and above and aged 50 years and above. The problem was confirmed during clinical examination with the examiner's finger pressure on the Tibia. The same-age control subjects were chosen from among patients without shin pain. The level of 25-hydroxyvitamin D (25OHD) was measured using ELISA method and 25OHDFINDINGS: In this research, 80 patients with mean age of 61±8.2 years and 59 control subjects with mean age of 62.3±9.1 years were studied. The level of 25OHD in patients was lower than control subjects (21±16 versus 37.4±21.6 ng/ml) (p=0.001), while BMI in patients was significantly higher than control subjects (p=0.001). Moreover, a significant relationship was observed between vitamin D deficiency and shin pain (OR=15.3 [8.5-40]), which was more severe among men.
According to the results of the resent study, the elderly patients with local pain and unexplained shin pain need to be examined in terms of vitamin D status and need to be treated in case of deficiency

Iatrogenic injury to the inferior alveolar nerve is one of the possible complications in surgical procedures such as implant placement. Considering the anatomic variety in nerve placement, the present study aims to assess the exact position of mandibular canal in the posterior mandibular body using cone beam computed tomography (CBCT).
CBCT mandible images of 150 patients with mean age of 45 years were used in this cross-sectional study. The cross-sectional profiles of each patient were measured at intervals of 5 mm, starting from 1 mm before mental foramen to the anterior border of the ramus in two age groups, below 50 and above 50. In each profile, the distances from the walls of the mandibular canal to the cranial nerve (CN), inferior nerve (IN), buccal nerve (BN) and lingual nerve (LN) were measured.
FINDINGS: 70 men with mean age of 48.91±13.46 years and 80 women with mean age of 41.56±14.41 years participated in this study. The mean distances (mm) on the right and the left were respectively as follows: CN: 10.67±3.83, 10.38±3.73, BN: 4.44±1.42, 4.31±1.37, LN: 2.23±1.15, 2.42±1.23, and IN: 5.75±1.86, 5.63±1.86. According to the separate analysis of the profiles, the mandibular canal in men was more inclined to lingual nerve in buccolingual dimension and was more inclined to the top of the alveolar ridge in the inferior alveolar dimension. In terms of age, the bone in the cranial nerve (CN) in patients under 50 years in all profiles was significantly more than patients above 50 years (p According to the results of this study, age and sex may have significant effect on the position of inferior alveolar nerve and the use of 3D radiographies such as cone beam computed tomography is essential

Self-reported health is a reliable indicator of health and a good indicator of mortality and morbidity, which is associated with several factors including demographic, socioeconomic, behavioral and psychological factors. This study aims to investigate self-reported health in women of reproductive age and its relationship with health-promoting behaviors and socio-demographic factors.
This cross-sectional study was conducted among 330 women of reproductive age admitted to selected health care centers in Qom in spring 2016. The women were categorized in two groups of good and poor health based on the self-reported health question "how would you describe your general health?". The health-promoting lifestyle profile II (HPLP II) questionnaire was used to assess health-promoting behaviors with the total possible score ranging from 52 to 208.
FINDINGS: The mean age of the studied women was 29.6 ± 6.2 years. T-test demonstrated that the mean scores of stress management (19.92±4.02), spiritual growth (26.33 ± 4.76) and nutrition (25.92 ± 4.66) in the women with good health were significantly higher compared to women with poor health (18.65 ± 4.61, 24.44 ± 5.55, 24.35 ± 4.89, respectively). In the final analysis based on the logistic regression model, only the factors of income adequacy for living expenses (CI=1.778-9.625, OR=4.136, P.V=0.001) and spiritual growth (CI=0.872-0.985, OR=0.926, P.V=0.04) remained as significant factors.
Considering the results of this study, income adequacy for living expenses and spiritual growth are the indicators associated with self-reported health in women of reproductive age.

Spiritual health is the basis of family and community health. In marital relationships, several factors led to the satisfaction of wives from each other. In the meantime, the role of spirituality is crucial from surrounded on all aspects of human life. This study was performed with aim of analyzing the relationship between spiritual health with marital satisfaction and Comparison of them between men and women.
The sectional study was conducted on 341 married students of Medical Sciences in Azad University, Sari branch. Criterion variable (spiritual health) and predictor variable (marital satisfaction) were measured by standard questionnaires including Paloutzian & Ellison (1982) and Enrich(2000) with 5-item Likert scale with a minimum score of 1 (very low) to maximum score of 5 (very high) and also two groups of men and women were compared.
FINDINGS: Spiritual health had direct and meaningful relationship with marital satisfaction (CI-95% R= 0.009).There was no difference of marital satisfaction in men with average of 3.36±0.35 and women with average of 3.44±0.43 (p=0.342) but, the spiritual health in men with average of 2.7±0.25 was more than women with average of 2.6±0.14 (p=0.000).
According the results, there was no difference of marital satisfaction in man and woman but, the spiritual health in men was more than women. Marital satisfaction had increased by increasing spiritual health in men and women students.

Exclusive breastfeeding for the term infant during the first six months of life fulfills all infant's needs, enhances the immune system, defends the infant against the number and intensity of infections and enhances the development of cognitive systems, social development and intellectual development of children. One reason for early cessation of breastfeeding is that mothers think their milk is inadequate for their infant. Therefore, the present study was conducted to enhance the adequacy of exclusive breastfeeding from the perspective of mothers using family-oriented educational-supportive programs.
In this randomized clinical trial, 70 pregnant women over 18 years old were selected with the following characteristics: first pregnancy, singleton, low risk and gestational age of 32 to 36 weeks. Mothers were randomly divided into intervention and control groups. Mothers in intervention group participated in 2 family-oriented educational sessions during pregnancy and participated in 1 family-oriented consultation session during the first week after delivery. Mothers in control group only benefited from routine educations. The adequacy of breastfeeding from the perspective of mothers and exclusive breastfeeding were assessed and recorded for both groups using a researcher-made questionnaire with a total score of 14-70 (IRCT2015081723657N1).
FINDINGS: During the first two weeks after delivery, the mean score of breastfeeding adequacy from mother’s perspective in the intervention group (64.88±4.78) was significantly higher than the control group (56.57±6.91) (P= 0.000). In addition, the difference was still significant during the first two months after delivery (67.33±3.58 and 57.20±7.94 for intervention and control groups, respectively, p=0.000). Moreover, the level of exclusive breastfeeding at the end of the second week (P=0.003) and the second month (p=0.01) revealed a significant difference between intervention and control groups.
The results of this study demonstrated that family-oriented educations and consultations during pregnancy and after delivery significantly enhances breastfeeding adequacy from the perspective of mothers and exclusive breastfeeding.

Most studies related to phrenic nerve are conducted based on an anatomical perspective and there is no histological study associated with this nerve. Since detecting the approximate time of death based on tissue destruction and determining the main branch of phrenic nerve based on the number of nerve fibers is extremely important, the histological examination of phrenic nerve was evaluated in the present study.
In this experimental study, the left and right phrenic nerves, obtained from 10 male corpses, were described using Grant's method of dissection after cutting the chest. In order to count the number of nerve fibers in the constituent branches (C3, C4 and C5), Hematoxylin and Eosin staining and Bielschowsky staining were used. In addition, to determine tissue destruction time, phrenic nerve of 8 rabbits were examined one to eight days after their death.
FINDINGS: The results regarding tissue destruction time demonstrated that phrenic nerve starts to degenerate on the sixth day after death and is completely degenerated on the seventh and eighth days. Moreover, mean nerve fibers in C3, C4 and C5 were 41.2% (2224), 44.9% (2428) and 13.9% (749), respectively. The differences between the number of nerve fibers in these branches was statistically significant (p The results of this study demonstrated that a significant part of phrenic nerve fibers are originated from C4 branch. In addition, tissue destruction of this nerve starts on the sixth day after death.

Nutrition and food consumption patterns have a very important role in the prevention of cardiovascular diseases. There are many clinical and epidemiological evidence regarding to cardiovascular health and food consumption and dietary patterns. Given the importance of this issue, in this study a review of various studies and sources about role of consumption of various food groups in prevention of cardiovascular diseases was performed.
In this study, new evidence on the role of major food groups in the prevention of cardiovascular disease were investigated by using various databases including pubmed, pubmed central, scopus, web of science and key words such as cardiovascular disease, food groups, dietary patterns and diet were used.
FINDINGS: According to the results of this study, diets containing fruits and vegetables because of their high fiber, antioxidants and minerals except sodium along with certain food groups such as grains, nuts, fish and low-fat dairy products are appropriate in the prevention of cardiovascular diseases.
Taken together, according to the results of this study, it can be considered that appropriate use of the major food groups has a significant role in the prevention of cardiovascular disease and should be an important part of a healthy lifestyle

Kawasaki disease is an acute febrile vasculitis of childhood. Infection is probably considered as a predisposing factor. According to low incidence of Kawasaki disease following the herpes simplex virus and to reduce mortality by early diagnosis and treatment of disease, a rare case of a patient with this disease will be introduced.
CASE REPORT: A 6-year-old male patient with fever, vomiting, decreased level of consciousness referred to the Tehran Children Medical Center. The patient had gradually loss of consciousness responding to painful stimuli and fever has been significant. He was treated with vancomycin and cefotaxime and acyclovir. After three days, the patient experienced partial recovery and lumbar puncture was done. PCR was done on cerebrospinal fluid which was positive for herpes virus type 1. During treatment the patient was suffered from scaling in the end of the fingers. Kawasaki disease was diagnosed and treated by measuring the levels of troponin, and echocardiography.
Due to the unusual symptoms of the kawasaki disease, taking into account the differential diagnosis of patients with febrile and non-febrile patients, even in the convalescent phase of infectious diseases is essential for early diagnosis and treatment.