فصلنامه یافته
سال یازدهم شماره 4 (پیاپی 37، زمستان 1388)

Appendix carcinoid tumors are of rare cases. Their commonest place is in digestive system in appendix intensine and rectom respectively. They have no symptoms and they are detected along with laparotomy or inflation in appendix. The aim of the present study was to determine the frequency of carcinoid tumor in appendix and its prognosis in a period of 3 to 8 years in Shohada hospital in khorramabad. The present study is a cross – sectional which was carried out on 2845 patients with appendectomy in Shohada hospital in khorramabad in 2003-2006. The needed data were collected through a questionnaire from the pationts files who had the tumor operation in the hospital. The data were analyzed using descriptive statistics. Then the patient's prognosis was determind. The results showed that among all the cases with tumors, three out of five were carcdinoids, one was mucucell, one was mucucell associated lymphoid tissue. In adition to these cases, one case was colon carcinoid related to metastatic΄s deodenom, but no adenocarcinoma tumor was observed. After pathological analysis, the results showed that none of the patients with carcinoid appendix needed any treatment in 3-8 years follow up program and there was no recurrent growth for the disease. As carcinoid in appendix can be malignant and spread over other tissues and causes short life, it needs special care and follow and the patients should be referred to the specialist to complete treatment. Carcinoid appendix should be considerd as a neoplasm since it has the special power of spreading and metastasis over distant tissues.

Menopause and decrease of estrogenic hormones lead to osteoporosis. Treatment of osteoporosis by estrogenic hormones like estrogen in women has resulted in secondary complications such as cancers of breast and genital system. Activity of osteoclasts for removing bone is necessary to secretion of H+ ions on bone matrix. Today, using proton pump inhibitors to inhibit the activity of osteoclasts is under study. In other hand, recent researches show that these inhibitors by decrease absorbing of calcium intestine, can increase the risk of fracture. According to physiology of osteoclasts and the vitamin D mechanism on absorbing calcium from intestine', the combined effect of vitamin D3 and omeprazole were studied. 64 female Sprague dawlley rats (160 to 180 gr) were selected and divided into 8 groups (8 in each): 1- Sham group, without ovariectomy, 2- ovariectomized group without treatment, 3- ovariectomized group, treated with vitamin D3 100 µg ∕ kg, 4- ovariectomized group,, treated with vitamin D3 400 µg ∕ kg, 5- ovariectomized group, treated with omeprazole 20 mg/ kg and vitamin D3 100 µg/kg, 6- ovariectomized group, treated with omeprazole 20 mg/ kg and vitamin D3 400 µg/kg, 7- ovariectomized group, treated with omeprazole 20 mg/ kg, 8- ovariectomized group, treated with DMSO as a solvent. A week after ovariectomy, treatment of 3th to 8th groups began and continued for 12 weeks. During the sampling, under general anesthesia, blood were sampled and serum was prepared, and then lumbar vertebrae, femur bones and the right tibia separated and were put in the fixative solution. Serum alkaline phosphatase and Ca were measured. Resistance of femur bones were measured against fracture. Histological section prepared from L3 vertebrae and the end of tibia bones. The volume density of trabeculae of the L3 vertebrae body of samples was measured by stereologic rules. The number of osteoclasts in tibia's sections was measured morphometrically, and the density of L4 vertebrae was determined based on Archimedes ' principle. The mean of variables was compared by SPSS 12 software. To compare the mean of alkaline phosphotase, serum Ca, the density of L4 vertebrae and the resistance of femur bones against fracture, we used ANOVA and Games-Howell's test, and to compare the mean of volume density of trabeculae and the number of osteoclasts, Mann- Whitney test in p<0. 05 was used. After 12 weeks, ovariectomy made severe osteoporosis in the 2nd and 7th groups. In the 1st, 3rh, 4th, 6th and 8th, no osteoporosis was delected, but in the 5th group, osteoporosis was detected slightly. Vitamin D treatment and almost DMSO prevent osteoporosis progressing. omeprazole treatment alone cant prevent osteoporosis but in combination with a suitable dose of vitamin D, it can prevent osteoporosis and its progress.

Oxidation of low-density lipoprotein (LDL) has been strongly suggested as a key factor in the pathogenesis of atherosclerosis. Thus the inclusion of some anti-oxidant compounds such as Satureja Khozistanica,vitamin E and coenzyme Q10 in daily dietary food stuff may inhibit the production of oxidized LDL and may decrease both the development and the progression of atherosclerosis. The present study investigated the inhibitory effects of Satureja Khozistanica, vitamin E and coenzyme Q10 on LDL peroxidation induced by CuSO4 quantitatively in vitro. LDL was incubated with CuSO4 and the formation of conjugated dienes and thiobarbituric acid reactive substances (TBARS) of LDL were monitored as markers of LDL oxidation. Inhibition of this Cu-induced oxidation was studied in the presence of extracts of Satureja Khozistanica,vitamin E and coenzyme Q10. It was demonstrated that Satureja Khozistanica like vitamin E and coenzyme Q10 is able to inhibit LDL oxidation and decrease the resistance of LDL against oxidation in vitro. This study showed that Satureja Khozistanica similar to vitamin E and coenzyme Q10 prevented the oxidation of LDL in vitro and it may suggest that they have the similar effect in vivo

Many hospitalized children are suffered from medical errors that may cause serious injuries. The aim of this study was to evaluate medical errors in hospitalized children in khorramabad Madani hospital in the first half of 2008. This study was a cross sectional that was performed for all medical errors in hospitalized children in khorramabad Madani hospital from 21/3/2008 to 21/9/2008. The sampling method was census. Studied variables included: age, sex, weight, kinds of errers, education of parents, job of parents. Data was collected by questionnaire and analyzed by SPSS software. In this study out of 2250 records, 151 (6/3%) had medical errors. 53%were girls and 47% were boys that there was a significant relation between sex and medical errors. 46/4%were related to age group lower than 2 years old. Most of the errors were occurred in weight group of 6kg. Types of medical errors included drug ordering 46/3% (involved incorrect dosage of drug (37%), frequency 28%, rout 19% and others 16%), transcribing10%, administering32/4%, dispensing11/3%. Most errors related to liquid therapy 76/2% and intravenous rout 85/4%. Most errors were occurred during night 47% and during weekend 56/6%. Medical errors are common in hospitalized patients, and in our study the rate of medical errors was 6/3%. So further efforts are needed to reduce them.

Breast cancer is the most common cancer among women and the third commonest cancer after stomach and lung cancers. Almost one out of nine women suffers from this cancer. About half million people die from breast cancer yearly. Therefore, it is necessary to pay attention and study this disease. In this cross-sectional study, a prepared questionnaire including presumable risk factors of breast cancer was completed by all the women suffering from breast cancer who referred to Shohada Ashayer hospital of Khorramabad from September 2008 to July 2009. Finally, the data of 50 patients was collected and analyzed to study probable risk factors of breast cancer. The results showed that the average age was about forty three, 38% and 8% of the patients were overweight and obese respectively in terms of BMI, 10% were single, and 38 (90. 5%) out of the 42 patients with childbirth record had been under 30 in their first childbirth. Moreover, seventy six patients had menarche age under thirteen. Nine (60%) out of fifteen patients had over-50 menopause, 38 (88. 1%) of the married patients with children had lactation record, 74% of the patients lacked mastalgia record, 80% did not report any biopsy record, and 45 (90%) of the patients did not report any breast cancer history in their close relatives. Considering the results of similar studies and factors including first childbirth age, lactation record, and the body mass index of most of the patients in the present study, as well as the life style and facilities in the province, it can be concluded that stressful events of life could be major factors in causing breast cancer in the studied patients

with industrial and economic growth and different material production that humans gained from natural resources for their comfort and walfare, inwardly introduced toxic material and heavy metal entered environment that there created serious problems for themselves and environment. This study accomplished to determine heavy metal concentration (As, Ba, Cd, Hg, Pb, Cr)in water resources and river of Borujerd city in 2008-2009. This descriptive cross-sectional study was conducted to determine heavy metal concentration (As, Ba, Cd, Hg, Pb, Cr) in water resources and river of Borujerd city. 54 samples of water were taken from 18 drinking water wells, and also in two times 8 samples of Borujerd river were taken from before and after the city. Then samples carried into the lab and were concentrated ten times using expressed methods and standard methods. Then heavy metal concentration determined by AAP (WFX 130) and results analyzed by SPSS and EXCEL software. Heavy metal concentration average (As, Ba, Cd, Hg, Pb, Cr) in drinking water wells were 0. 0, 0. 3222, 0. 0014, 0. 0002, 0. 0077 mg/l respectively. and heavy metal concentration in river water after the city has been increased than before the city. Results indicated that heavy metal concentration average in Borujerd drinking water wells were lower than standard amounts and drinking water wells didn’t pollute with heavy metal. But heavy metal concentration in river water after the city has been increased than the before of it because city waste water enters the city river.

The carried out studies show that psychological, emotive and social problems of students are important and need to serious and organized measures to select tutors. It is clear that lack of rendering suitable counseling prevents students from educational attainments. So with regard to importance and role of counseling, this research was carried out to determine the rate of student's satisfaction from academic counseling of the tutors of Lorestan university of medical sciences. This descriptive cross-sectional study was carried out on 680 students including the third and forth term of all fields selected using census sampling. Data collection tool was a two part questionnaire (reliability = %79) which indicated student's satisfaction in three levels. Then data were analyzed using statistical tests, X2 and SPSS software. In this study 77. 9% of the students were female with age range of 19-35. The most reason for their referrals was educational problems (59. 2%). 37. 9% of the students had no satisfaction from the tutors, 44. 38% had moderate satisfaction and 17. 73% of them were satisfied with the tutors. Results indicated a weak level of satisfactory, so having positive, attitude towards academic counseling, it seems necessary to take action for implementing laws and regulations related to tutors, as well as evaluating their performances. Conducting codified educational programs for tutors can help achieving university high goals.

Dental caries is a transmissible infectious disease which is the most common disease in human being after the common cold. The most permanent tooth which is decayed at the age 6-12, is the first molar of the tooth of sixth year. It is the main base for chewing and the leader of growth for the rest of tooth, and losing it leads to irreparable damage within mouth and tooth limit. Having it out is like snapping the string of a chaplet and causes the disturbance of dental harmony. Therefore it may lead to particular, temporal and jaw aches (t. m. g) and may cause headache and aches in jaw and lace. This study in addition to defining the index of DMF in different parts of khorramabad, it investigates the relationship between decay, brushing, the number of family members and education of parents. This cross-sectional study was carried out on 920 khorramabad primary school students in 2007 to determine the DMF. The metod of sampling was a combination of classification and multiphase cluster sampling. Data were recorded in a questionaire which was prepared for this purpose, then they were analyzed using SPSS software. Also, for the cases which needed to be compared, the Mann-whithney and t-test were used. After examining the students to define the DMF, it was determined that 53. 2% of the students had no carious tooth and among those students who had carious teeth 35% had one, 32. 7% had two and the others had more than two carious teeth. The average of DMF for all the students was 1.02 which this value was 1. 13 for girls and 0. 95 for boys. Maximal average of DMF for 11 year old girls was 1.71 and for 11 year old boys was 1.05 and minimal average of DMF for 7 year old girls was 0.25 for and 7-year-old boys was 0.27. Also maximal average of DMF in health care centers of Dar-e garm was 1.73 and minimal value in health care centers of Shafa was 0.54. So, maximal average of DMF in 11 year old students was 1.6 and minimal average of DMF and in 7 year olds was 0.28. By comparison between the average DMF of students of khorramabad and national standard, it was seen that the difference between the average of DMF of 7 year old students and national standard was not significant, but the difference between 9 years old students and national standard was significant. Also, no significant difference was observed between MDF mean of those who brushed their teeth and those who did not.

Musculoskeletal disorders, early fatigue induced by static work and the same symptoms are caused by inappropriate designed tools, equipment, building and workplace. Inadequate educational furniture is taken to be the reason of severe posture problems such as low back pain, spinal disorders, fatigue, shoulder and neck pain, and disturbance circulation in legs. So ergonomic design of educational furniture should be carefully considered. The present research was a cross-sectional study. Samples included desks and chairs (n=150) chosen from reading rooms of dormitories and faculties of Isfahan university of medical sciences Isfahan- Iran. In the study 2 parameters from desk and 5 parameters from chairs were assessed using a tape-measure and a set-sqare. Data were analyzed by SPSS ver 10 software. Comparing the results from the mean of measured values (for seating height, desk height and desk clearance) indicated a significant difference between them (p<0. 00). Findings of the study showed that existing standard in Iran about chairs and tables for educational institutions should be reviewed. Also the most important problem with chairs and desks are seating height and desk surface height respectively. These two parameters didn’t match with anthropometric dimensions of the sudents of Isfahan university of medical sciences.

Celiac disease (CD) is a chronic enteropathy caused by hypersensitivity to gluten. Most studies have showed more prevalence of CD in the patients with diabetes mellitus type 1. Both diseases are autoimmune and their incidence is related to inheritance and environmental factors. The aim of this research is the study of relation between CD prevalence and diabetic age onset.

In this descriptive cross-sectional study, 135 children with diabetes mellitus type 1 referring to Tabriz children hospital endocrine department and clinic between 2006-2008 were selected. After filling individual identity of the patients and the measurement of weight and height, the serumic level of anti-tissue Trans glutaminase IgA antibody (A-tTG-A-IgA), anti endomisial IgA antibody (AEA-IgA) and anti-gliadin IgG antibody (AGA-IgG) were measured. In the case that A-tTG-A either AEA alone or with AGA was high, small intestinal biopsy was preformed. The data was analysed using SPSS ver 16 software.

28 of 135 patients with diabetes mellitus type 1, were serologically positive for celiac. Confirmed celiac prevalence based on biopsy was 6. 8%. From diabetic age onset and celiac incidence point of view there was not any significant relation (P=0. 996).

Celiac disease in type1 diabetic patients dose not have correlation with the onset age of type 1 diabetes and diabetic patients should be followed up from celiac point of view during treatment and prevention.

Hyperlepidemy or the increase in the rate of blood lipids is a condition which is developing as an illness in new decades. With regard to problems as a result of using drugs and also benefits of physical activity to improve hyperlepidemia, this research has tried to study the effect of the physical activity with regard to energy expenditure on blood lipids. To do the study, 21 hyperlepidemic men were selected and received a training protocol (the physical activity with 450 and 600 kcal). Results showed that burning 450 kcal per season caused a significant change at levels of total cholesterol and HDL (P≤0/05). However to cause significant changes at levels of the triglyceride need to burn 600 kcal energy expenditure per season (P≤0/05). No significant change was found for both groups in relation to LDL levels and so can be concluded that, burning 600 kcal per session is not enough to cause change at LDL levels. In general, results showed that to cause positive changes at levels of HDL, less physical activity is needed, but to cause positive changes at levels of triglyceride, physical activity and energy expenditure should be increased.

One of disorder with destroyed of function and perception of body’s structure is cerebrovascular accident (CVA). By current statistical results, CVA is the third agents of death. Self care is the one section of rehabilitation in patients with CVA. By nurse’s support, the patient will performance self care and he will acquire feeling self- respect. This quasi experimental research was carried out on 42 CVA patients. Data collection instrument was SS- QOL questionnaire. First QOL indicator was measured by SS- QOL questionnaire. In experimental group self care program was instructed. After 5 weeks, patient’s QOL in two groups were measured again by the same questionnaire. T test, Chi Square and Willcaxon test was used to data analysis. A significant difference was observed between QOL score before and after self care program in experimental group (p≥0.001), as well as a significant difference was seen between QOL score in experimental and control groups (p≥0.00128). Findings of this research showed that education of self care to patients by nurses in hospital or home can increase quality of life in the patients with CVA.

For all individuals, mental, physical and social health is vital strands of life that are closely interwoven and deeply interdependent. And mental health is crucial to the overall well-being of individuals, societies and countries. The aim of this study is to identify the mental health needs of Hamedanian people. This was a descriptive cross-sectional study. The participants consist of 1300 persons who were selected by stratified sampling. A 30- item questionnaire was used to gather data from the samples. It consisted of three parts: A-demographic factors, B-questions related to mental health service delivery and C- questions related to mental health needs. Results showed that the Hamedan city people believed that mental health services are inadequate, they did not access services near their home (76%) and mass media educational programs about services was poor(34%). The expressed needs of people were: mental health education (72%), established mental health centers in schools (52. 8%) and factories (50. 7%) and expanding the comprehensive mental health centers in the city(57. 8%). Expanding the assurance services (85. 6%), modifying wrong beliefs and ideas about mental illness (42. 6%), and improving the mental health in society. Community based mental health services should to provide comprehensive and local cares and treatments. Services should be comprehensive in that they provide a range of facilities to meet the mental health needs of the population at large as well as of special groups, such as children, adolescents, women and elderly people.