مجله دانشگاه علوم پزشکی قم
سال هفتم شماره 2 (پیاپی 26، خرداد و تیر 1392)

Injection is one of the most painful and common medical interventions that more than 12 billion of it are administered annually throughout the world. In spite of the wide use of this intervention, its associated pain remains as one of the unsolved health problems. So, this study was performed in order to determine the effect of multiple blunt pins pressure on the pain of intramuscular injection site. This study was conducted as a single-blind randomized clinical trial at the injection section of kamkar-Arabnia Hospital in Qom, 2011-12. In this Study, 50 women aged from 16 to 60 years who had intramuscular injection of penicillin 6.3.3 were randomly assigned to two equal groups. The first group received intramuscular injection using a plastic device (an oval disc that supports multiple blunt pins) and in the second group (control), routine injection was performed. Pain was measured using a visual analogue scale. Data were analyzed by chi-square, Fisher’s exact, independent t, kolmogorov-Smirnov, and Levene tests. The mean pain intensities in experimental and control groups were 27.04±8.6 and 36.6±14.1, respectively. After intramuscular injection, the pain intensity significantly decreased in the experimental group compared to control group (p<0.006). There was no significant statistical difference between the two groups in age and BMI. The results of this study showed that pressure on the skin with multiple blunt pins is highly effective in reducing the pain of intramuscular injection.

Chromium is one of the most important heavy metals, which its high levels in drinking water lead to several health adverse effects. This study was performed aiming at determining the effects of primary concentration of six-valent chromium, adsorbent dosage, contact time, and pH on the adsorption of chromium from water on bone char. Bone char was prepared using electric furnace at 450°C for 2 h. Pulverizing of bone char was carried out by standard ASTM sieves with the range of 0.5-1 mm. The structural characteristics and specific surface area were determined through conventional methods. The sample's chromium concentration was measured at a wavelength of 450 nm. Adsorption isotherm of chromium was assessed by Freundlich, Langmuir, and Temkin adsorption equation models. The main component of Bone char is calcium hydroxylapatite with surface area of 100m2/g. In this study, adsorption reached the equilibrium at lapse of 120 min, and the increase of adsorbent dose up to 0.7g/100ml leaded to increase in the chromium adsorption. However, higher level had no effect on adsorption efficiency. The results showed optimum adsorption took place better in acidic range of pH (pH=3). Adsorption isotherm of chromium on bone char follows the Langmuir and Temkin models, and the maximum adsorption capacity the dimensionless coefficient (RL) were 2.025 mg/g and 0.15, respectively which indicates that an appropriate adsorption of chromium on bone char. Bone char is an inexpensive adsorbent, which can be used for adsorption of chromium from water based on surface properties.

Formaldehyde is one of the toxic volatile organic compounds which is necessary to be removed from polluted air. Photocatalysis is one of existing technologies used for the removal of this compound. This study was performed aimed at determination of the effect of the combination of zinc oxide (ZnO) nanoparticles and bone char (BC) on the photocatalytic removal of formaldehyde gas.

In this experimental study, characteristics of the catalysts produced by specific surface area were determinated using BET method and scanning electron micrograph (SEM). The degradation of formaldehyde gas was studied using UV/BC, UV/ ZnO, and UV/ZnO-BC processes, under the continuous flow mode condition. The effects of initial concentration, relative humidity, and residence time on degradation of formaldehyde gas were investigated.

The results of the BET surface area measurements and SEM images showed agglomeration of ZnO nanoparticle on the pores of the BC surface structure. The SEM imaging from ZnO-BC catalyst showed that the BC particles pores filled with ZnO nanoparticles formed a homogenous surface. Also, the combination of BC with ZnO nanoparticles had a synergetic effect on the photocatalytic degradation of formaldehyde. In UV/ZnO-BC process in the initial concentration range between 2.5-25mg/m3, the degradation efficiency of formaldehyde was between 40% and 73% and the optimum relative humidity was 35%. This effect seems to be due to the strong adsorption of the formaldehyde molecule on BC that results in higher diffusion to the ZnO catalytic surface and that increase in the rate of photocatalysis.

Increase in the formaldehyde degradation by the ZnO-BC composite can be attributed to the synergetic effect of adsorption and subsequent photocatalytic decomposition.

In order to evaluate the functional changes of liver after lead intoxication, activity of enzymes, including alanine aminotransferase (ALT), aspartate aminotransferase (AST), and alkaline phosphatase (ALP), as well as pathological changes of the liver were assessed in the present study. Male and female Albino Rats (40 in total) in five 8-rat groups were exposed to 0, 5, 10, 15, and 40mg lead acetate dissolved in 1 liter drinking water, from the onset of embryonic life to 16th week of life. At the end of 16th week, the animals were anesthetized with chloroform, and blood sampling from heart was performed. After serum separation for biochemical analysis, liver was taken out and fixed in 15% formalin for histopathological studies. Activity of ALT, AST, and ALP, as well as lead concentration of the serum samples were measured using spectrophotometrical method and graphite furnace atomic absorption, respectively. The tissue sections were histologically studied under light microscopy after staining by hematoxylin/eosin. The results were analyzed using analysis of variance and Tukey's test, and p<0.05 was considered significant. In this study, liver enzymes activities had direct relation with the serum lead concentration, and showed a significant increase compared to the control groups. Histological changes were observed as inflammation, lymphocyte infiltration to liver tissue, and liver cells necrosis. According to the results of this study, long-time exposure to lead results in dose- and time-dependent liver injury.

Postpartum depression is one of most important health problems in women. This study was performed with the purpose of comparing the frequency of postpartum depression in pregnant women with emotion and problem-focused coping strategies.

This study was conducted as a prospective cohort study on 200 pregnant women with stress (low and high levels). The samples were pregnant women referred to all health-treatment, centers of Ardabil, which were selected using a multi-stage sampling method; and according to coping strategy, they were divided into two groups: emotion-focused and problem-focused. Low-risk pregnant women completed questionnaires about demographic characteristics, perceived stress, and Billings and Moos coping strategies in the 38th to 42th week of their pregnancy, and completed the Edinburgh depression scale in the 3th to 4th weeks after childbirth. Data were analyzed using chi 2 and t tests. p<0.05 considered significant.

In this study, 170 participant women (85%) used emotion-focused strategy and 30 women (15%) used problem-focused strategy. Frequency of postpartum depression was 6.7% in the problem-focused group and 8.2% in the emotion-focused group. There was no significant difference in the frequency of postpartum depression between women with the problem- and emotion-focused strategies. Relative risk for postpartum depression was 1.2 times more among the women used emotion-focused strategy than women used problem-focused strategy (p<0.05).

According to the results of this study, there was no significant relationship between postpartum depression and the two emotion-focused and problem-focused coping strategies. This can be due to high influence of postpartum specific endocrine factors in the etiology of this type of depression compared to other depressions.

Enhancement of empowerment in patients with coronary artery disease has a major role in the promotion of their health behaviors. Promotion of self-efficacy is a one of the ways for improving this skill, which has a significant impact on improving patients’ condition and on preventing complications and readmission. The objective of this study was to determine the predictors of general, exercise, and diet behavior self-efficacies in coronary artery disease patients. In this cross-sectional study, 195 patients with coronary artery disease referred to the Heart Clinic of Educational Treatment Center of Dr Heshmat Hospital in Rasht, were selected through convenient sampling and were surveyed through questionnaires about illness perception, general self-efficacy, exercise self-efficacy and diet behavior self-efficacy. The Chi 2 test was used to examine the relations between variables, and the multiple logistic regression test was used to determine the predictors. In this study, 74.9% of samples had desirable general self-efficacy, 86.2% had desirable diet self-efficacy, and 28.2% had desirable exercise self-efficacy. In addition, variables such as age, sex, diagnosis of heart disease, and illness perception were predictors of general self-efficacy. Occupational status and illness perception variables were the predictors of exercise self-efficacy; and the predictor of diet self-efficacy was illness perception. Considering the results of this research, it seems that more precise plannings are needed for the promotion of exercise self-efficacy in coronary artery disease patients.

Acute Myocardial Infarction is a rare complication of Mitral Stenosis, which in rare cases occurs following the use of oral contraceptive pills.Case Report: A 28-year-old woman was admitted to emergency ward with complaint of severe chest pain typical of is chemia. Electrocardiogram showed ST segment elevation in leads II, III, avf, and ST depression in anterior leads. Also, Troponin I level elevated to 16µg/l. Diagnosis of MI of the inferior and lateral walls was established. The patient reported a history of breathlessness after physical activity over the last 2 years, and was aware of her mitral disease. Also, the patient stated that she had been taking oral contraceptive pills over the past 3 months. Transthorasic echocardiography showed severe mitral stenosis (mitral valve area<1cm), and severe hypokinesia of inferior and laterel walls. Coronary arteries were normal in cardiac angiography. It seemed that acute MI in this patient with valvular heart disease, history of OCP use, and normal angiogram was due to thromboembolism from left atrial thrombus.