مجله دانشگاه علوم پزشکی قم
سال سیزدهم شماره 1 (پیاپی 84، فروردین 1398)

Multiple sclerosis (MS) is a chronic disease of central nervous system, which causes a lot of complications and problems for patients and leads to their disability and dependency in life. The aim of this study was to determine the effectiveness of self-care training program on controlling disease-related complications in women with multiple sclerosis.   In this interventional study, 70 women with multiple sclerosis were selected by simple random sampling. The selected subjects were randomly assigned to two groups of intervention and control. Data were collected using a researcher-made questionnaire and completed by structured interview. The training classes were held in two sessions for the test group and the questionnaires were completed again by both groups three months later. Data were analyzed using independent t-, paired t-, Chi-square, Fisher exact, and Mann-Whitney tests.   The mean score of self-care of the patients in the intervention group significantly increased after the intervention; so that their mean score increased from 35.42 to 59.51 (p<0.05). Moreover, Before the intervention, the mean score of muscle cramp of the intervention group, was 3.4; fatigue, 4.14; constipation, 3.17; and amnesia, 3.25; But after self-care training program, this mean decreased to 1.91, fatigue to 2.68, constipation to 1.2, and amnesia to 1.71 (p<0.05).   Reduction in MS physical complications in the intervention group, as compared to the control group, was indicative of the positive effect of the training program. Therefore, it seems that training these patients and encouraging them to perform the self-care program can have beneficial results.

Limited data are available on the relationship between dietary factors and risk of glioma. The current study was conducted to investigate the association between dietary acid load (DAL) and risk of glioma in Iranian adults.   This case-control study was carried out on 128 patients with glioma and 256 healthy subjects (Matched for age and sex) in Tehran, Iran. A validated detailed food frequency questionnaire (FFQ) was used to assess dietary intakes of the participants. DAL was estimated using the protein to potassium ratio (Pro/K) and Glioma was diagnosed based on pathological tests. A detailed questionnaire including several non-dietary confounders was also completed.   In this study, the participants in the highest tertile of DAL score had a non-significant higher risk of developing glioma as compared to those in the lowest tertile (OR: 1.50; 95% CI: 0.88-2.57). After adjusting the confounding factors, those in the highest tertile of DAL score, were significantly more likely to develop glioma than those in the lowest tertile (OR: 1.87; 95% CI: 1.02-3.45). No significant effect was observed after further adjustment for dietary intakes of meats and processed meats, grains and nuts, fruits, tea, and coffee (OR: 1.97; 95% CI: 1.06, 3.65; p=0.03) and body mass index (OR: 1.96; 95% CI: 1.06, 3.64; p=0.03).   The results of this study was indicative of a significant positive association between dietary acid load, as estimated by Pro / K ratio, and risk of developing glioma among adults. Further studies, especially prospective cohorts with long-term follow up, are required to confirm these findings.

Nonylphenol (NP), is a type of environmental chemicals, which is thought to act as androgenic hormones, inhibit the actions of hormones, and induce reproductive abnormalities and oxidative stress. In this study, the protective effect of Satureja khuzistanica (SJKH) on in vitro fertilization of adult male mice treated with nonyl phenol (NP), was investigated.   In this experimental study, 24 adult male mice (8 weeks of age), were randomly divided into three groups (n=8), including control group receiving corn oil, group receiving NP (250mg/kg bw), and group receiving NP+SJKH essential oil group (250 and 225mg/kg bw, respectively) orally by gavage for 35 consecutive days. At the end of the treatment period, animals were sacrificed and sperm sample was taken from caudal epididymis. For each male mouse, 3 female mice were considered. Then, ovulation was induced by PMSG and hCG to collect oocyte. In vitro fertilization was performed in the culture medium (HTF+4mg/ml BSA), the fertilized oocytes were incubated for 120 hours and embryo development stages were studied. The results of in vitro fertilization rate of sperms indicated decreased fertilization rate, percentage of 2-cell embryos, and quality of blastocyst and embryo in NP group compared to the control and experimental groups and also a significant increase in these parameters in the experimental group compared to the NP group. The result of this study revealed that SJKH as an antioxidant can decrease the toxic effects of NP on the fertility rate of adult male mice.

The most common type of cancer in children is leukemia, and most common type of which in children under the age of 19 years is acute lymphoblastic leukemia. The survival of the affected children varies from region to region. The aim of this study was to determine the five-year survival of children with acute lymphatic leukemia and its related factors in Qom Children Hospital.   This historical cohort study was carried out using data obtained from children’s records that were diagnosed with acute lymphoblastic leukemia from 2007 to 2017. The extracted data included age, gender, family history of leukemia, history of radiation therapy and radiation, history of contact with chemicals, parental occupation, living area, blood type and type of leukemia, tests, and initial examinations of the patient. Data were analyzed using Kaplan Meier charts and Cox survival analysis. The level of significance was considered less than 0.05.   In this study, a total of 97 patients were studied. The mean age of the patients was 5.12±3.99 years, and 55.67% (54 subjects) were male. The five-year survival rate of children was 65.10%. Among the studied factors, only the age of diagnosis and history of recurrence was significantly associated with the survival of patients, so that the survival was lower in the patients who had less than one year of age or had a history of recurrence.   The findings of the present study showed that the survival of children with acute lymphoblastic leukemia in Qom province is lower than that in other studies. Moreover, the survival of children was associated with age of developing the disease and history of recurrence variables.

Few studies have been performed on the adherence to the Mediterranean diet in relation to psychological health, particularly in the Middle East region. In the present study, the association between adherence to Mediterranean dietary pattern and psychological disorders (including depression, anxiety, and psychological distress), was investigated among a large population of Iranian adults.   This cross-sectional study was performed on 3172 adults (aged 18-55 years). The Mediterranean regimen model, was derived from the Trichopoulou et al. method. To investigate the relationship between Mediterranean diet and mental disorders, logistic regression was used with three modified models. In addition to the Mediterranean diet, the same analysis was performed for that pattern of food associated with psychological disorders.   The participants with the highest adherence to the Mediterranean diet had lower risk for depression (OR: 0.60, 95% CI: 0.46-0.78), anxiety (OR: 0.61, 95% CI: 0.42-0.86), and psychological distress (OR: 0.60, 95% CI: 0.45-0.79) compared to those with the lowest adherence. high intake of fruits and vegetables was associated with a lower risk of depression (Fruits: OR: 0.41; 95% CI: 0.31-0.54 and vegetables: OR: 0.53; 95% CI: 0.40-0.70), anxiety (Fruits: OR: 0.56; 95% CI: 0.39-0.79; vegetables: OR: 0.57; 95% CI: 0.39-0.84), and psychological distress (Fruits: OR: 0.47; 95% CI: 0.36-0.63; vegetables: OR: 0.46; 95% CI: 0.34-0.62). In contrast, high intake of grains was positively associated with depression (OR: 1.59, 95% CI: 1.12-2.27), anxiety (OR: 1.77, 95% CI: 1.11-2.82) and psychological distress (OR: 1.69, 95% CI: 1.16-2.45).   The findings of this study indicated an inverse association between adherence to Mediterranean dietary pattern and risk of psychological disorders (such as depression, anxiety, and psychological distress).

Medication errors can cause serious problems in health systems and is considered as a threat for patient safety. The purpose of this study was to investigate the types and causes of medication errors as well as their non-reporting and their relationship in nurses.   The present investigation was performed as a descriptive analytical study on nurses working in Shahid Beheshti Hospital of Qom city in 2017. Sampling was done by simple random method and 200 subjects were selected. The data collection tool was a four-part questionnaire (demographic characteristics, types of medication errors, causes of mistakes and failure to report). The data were analyzed by Pearson correlation coefficient.   The most common errors was occurred by nurses in the emergency and surgical ward and the lowest errors occurred in the pediatric ward. Also, there was no statistically significant relationship between the types of medication errors and the causes of errors due to the nurse related factors, department, and nursing management, and no significant relationship was seen between different types of medication errors and causes of statistical non-reporting.   Based on the results of this study, it is possible that there are other factors affecting the medication errors of nurses in Shahid Beheshti Hospital of Qom city, which are much more important than the factors mentioned in this study.

Urinary tract infection is one of the most common diseases of the urinary tract and is one of the common infections in infants and children. One of the risk factors for urinary tract infection in children is lack of diaper hygiene. Therefore, in the present study, the relationship between diaper hygiene related factors and urinary tract infection in children, was investigated.   This case-control study was performed on 150 children hospitalized in different wards of specialized educational pediatric Hospital. The case group was selected from hospitalized patients with urinary tract infection and the control group from different hospital wards. The data collection tool was a questionnaire consisting of three sections, including: the first part related to the demographic information of mother, the second part was the factors related to the child, and the third part was the factors related to diaper hygiene. Data were analyzed using independent t-test and Chi-square test.   In this study, type of child care, income of mother, education level of mother, and type of the diaper (p=0.001) and time of diaper changing (p<0.001) were related to developing urinary tract infection.   The results of this study showed that the hygiene of diaper could be related to urinary tract infection. Considering the high prevalence of urinary tract infection in children under three years of age, educational interventions are suggested to increase knowledge and preventive behaviors.

The tendency to leave nursing profession can exacerbate the shortage of nursing workforce and ultimately will have negative effects on the quality of health care provision. The aim of this study was to determine the tendency to leave nursing profession at the therapeutic and educational centers of Qom city.   This cross-sectional study was carried out on nurses working in therapeutic and educational centers affiliated to Qom University of Medical Sciences. After preparation of the list of nurses, 207 nurses were selected by simple random sampling method from 6 therapeutic and educational centers. First, the participants completed the demographic information questionnaire, then, the tendency to leave nursing profession was assessed as one question. Descriptive statistical indexes and multivariate logistic regression were used for data analysis.   The tendency to leave nursing profession among the participants was 54.6%. The rate of tendency to leave nursing profession among male nurses was 2.5 times higher than that of females (OR: 2.55, 95% CI: 1.03-6.31). Moreover, multivariate logistic regression analysis indicated that working in the fix morning shift in internal-surgical ward, having less than 10 years of work experience, and having overtime significantly increases the tendency to leave nursing profession.   Based on the findings of the present study, tendency to leave nursing profession in therapeutic and educational centers of Qom city is significant; therefore, given the variables affecting the increase of this phenomenon among nurses, a comprehensive program should be designed to improve this variable and its consequences.

Nowadays, Silybum Marianum (Milk thistle) is used for prevention and treatment of disorders, such as liver failure, non-alcoholic fatty liver disease, diabetes, and infectious, hematologic, and skin diseases. The aim of this review study was to investigate the view of Iranian traditional medicine on this plant and its comparative analysis with new studies.   In this review study, at first Silybum Marianum and its therapeutic use, were searched in Iranian traditional medicine references. Then, its therapeutic effects were studied in databases, such as PubMed, Google scholar, and SID using terms, such as diabetes, liver and kidney disease, cancer, and skin ; then, the uses of this plant in new medicine and Iranian traditional medicine, were compared.   In traditional medicine, Silybum marianum has been introduced as "Harshfe Barry" and uses for the treatment of liver, gallbladder, and skin diseases, swelling, and strengthening digestion; Today, in many studies, the effects of this plant have been studied, and properties, such as treatment of liver, kidney, and skin diseases, blood glucose control and lipid metabolism, strengthening the immune system and its anticancer effects have been proven.   The results of this study showed that some of the properties of Milk thistle, such as protection and the treatment of liver diseases, treatment of skin disorders, and anticancer effects that have been proven in recent studies are referred to in traditional medicine texts; therefore, it seems that traditional medicine combinations can be useful in modern medical interventions.