مجله دانشگاه علوم پزشکی ایلام
سال بیست و پنجم شماره 6 (پیاپی 107، بهمن 1396)

One of the challenges of patients with irritable bowel syndrome is the quality of life and perception of the disease. In recent decade's mindfulness as one of the most effective treatments in the treatment of many disorders has been introduced. This study aimed to determine the effectiveness of mindfulness therapy on quality of life and perception of disease among patients with irritable bowel syndrome.
The research method was experimental (pretest-posttest control group and random assignment).The sample of the study consisted of 30 patients with irritable bowel syndrome who among all patients were admitted to hospitals in 2014. After the interview, the Rome-III diagnostic criteria and Quality of life and illness perception questionnaire, using random sampling (n=15 per group) the subjects were selected and randomly divided into two experimental groups and one control. Two months after the completion of 8 sessions (90-minute sessions a week for two months) of treatment, mindfulness and perceived quality of life questionnaire was administered to the patients in both groups. Using multivariate analysis of variance, SPSS vol.20 software was also used to analyze the data.
Findings: Mindfulness therapy in improving quality of life (P=0.005) and increasing the understanding of the disease (P=0.002) among patients with irritable bowel syndrome in the experimental group was significantly effective.
Discussion & It seems that the implementation of mindfulness therapy can improve the quality of life and perception of disease in patients with irritable bowel syndrome.

Investigations have shown that the emotional stress during the pregnancy period could have sustainable effects on the embryo .In High Risk Pregnant women the risk of babies with health, behavioral, and mood problems will be more. Different investigations have shown that the effect of relaxation training on emotional stress .This study was conducted to investigate the effect of progressive Muscle Relaxation Training on infant's outcome such as Apgar index, weight, height, head circumference, and jaundice in infants after delivery in High Risk pregnant women.
The present study was done as a clinical trial on 150 High Risk Pregnant Women referred to Health and Medical Center in the city of Shahreza on 1392 -1393. High risk pregnant women were randomly divided into two groups. The control group only received routine pregnancy care and case group received routine pregnancy care and Progressive Muscle Relaxation Training (Jacobsen). At the time of delivery, infant's outcome including Apgar index, weight and height, head circumference, and jaundice was assessed.
Findings: Intervention and control groups in terms of demographic and obstetric variables were not significant (P>0/05). The results showed a significant difference between the two groups in height, weight, and head circumference (pvalueDiscussion & According to this study, progressive muscle relaxation training is promoting and improving the health of infants in high-risk pregnant women. The progressive muscle relaxation training can be safe and beneficial to pregnant women in order to improve the health of infants.

After the engineering noise control and management control, the last way for controling noise is using the hearing protective devices, whose effectiveness depends on full-time use of it. Due to the lack of a standard questionnaire about increasing the duration of worker's usage of hearing protection devices based on BASNEF behavioral pattern, this study has been done to design and measures this tool psychometrically.
The initial questionnaire of this study is drawn out of the texts, similar articles, and questionnaires. Face Validity and Content validity are measured by Lavsheh method based on obtaining the view of experts’ panel and the reliability was done by cronbach's alpha coefficient by tile industry workers. All analyses were performed using 19 SPSS software.
Findings: face validity and content validity of 49 items were identified. In professional content evaluation, CVR of items up to 60% were selected and the CVI of the remaining questions became 0.79%. The reliability of each of below indexes was approved as follow: knowledge: 82%, attitude: 88%, abstract norms: 83%, enabling factors: 88%, behavioral intention: 96% function: 89% and the overall reliability of research tool were approved by measuring Cronbach's alpha as 88%.
Discussion & Conlusions: vThese results introduced good evidence about the validity and the reliability of measurement tools on BASNEF model in increasing duration of workers usage of hearing protection devices.

The duration of using hearing protection device affects the performance of hearing protection. Most of performed trainings in various industries are to increase person’s knowledge about the way of using the hearing protection device not increasing the duration of using it which needs more investigation.
In this cross-sectional study by Basnef questionnaire, the data was collected just before training intervention and 3 months after that. The training intervention was performed as 5 training sessions by lecture, questioning, and answering. SMS and posters reminded the main training points.
Findings: Mean score at all areas of Basnef model increased after training intervention that was significant statistically (p-valueDiscussion & The results show that abstract norms construct was effective in increasing the duration of using the hearing protection device; therefore, it is recommended to be intentioned in planning and training intervention.

Increase in the consumption of nano zinc oxide in medicine, manufacturing cosmetic products, and in research has raised the questions about their toxicity. Because of the small size of nano materials its absorption by the digestive system is simple. In this study, the effects of nano zinc oxide have been investigated in vivo on the ileum tissue of adult NMRI male mice.
In this experimental study, male mice were randomly divided into five groups, including control, sham, and three experimental groups. 10-30 nm-sized zinc oxide (ZnO) nanoparticles were injected intraperitoneally in three concentrations, 100-300-500mg/kg for 21 days. Histological changes including; height and width of the ileum villus, the thickness of the muscle tissue and epithelium tissue, width of connective tissue, diameter of crypts, and goblet cell numbers were studied by One Way ANOVA and Tukey-Kramer posttest, after treatments.
Findings: The results showed that nano zinc oxide had no effect on the height and the width of villi and diameter of crypts, but reduced the width of lamina propria and goblet cells of and increased the width of epithelium and muscle tissue ileum (P Discussion & The height and the width of villi and crypts diameter in the experimental groups had no significant difference compared to the sham and control groups. However, the width of the lamina propria and the number of goblet cells decreased significantly in all experimental groups, which indicated low toxicity of nano zinc oxide in these doses. A significant increase was observed in epithelium and muscle tissue compared to the control and sham groups. It seems that nano zinc oxide could be increase the growth of epithelial cells. Due to changes in the intestinal epithelium tissue in adjacent to nano zinc oxide, the long- term use of this material should be avoided.

Urinary incontinence (UI) is a global problem that affects physical - emotional and social lives of women.The aim of this study was to evaluate the prevalence and demographic and obstetric predisposing factors of urinary incontinence in reproductive age women.
This cross sectional study was conducted on 2000 reproductive age women. The women were selected randomly from all of the primary health care centers of Dezful. Data were collected by socio demographic and ICIQ questionnaires.
Findings: Among participants, 57/7 % of the patients had urinary incontinence. There was a significant association between age, BMI, education level, mean of pregnancy, mean of deliveries, mode of delivery, abortion, neonate>4 kg, irregular menstruation, and UI(PDiscussion & The prevalence of urinary incontinence in reproductive age women is high. It is suggested that the health care providers pay more attention to this issue in health care centers and train women in the prevention of urinary incontinence.

One of the most common applications of medical isotopes is in treatment of cancer and hyperthyroidism using Iodine-131. The Iodine-131 cumulates in cancerous cells and acts as a source of radioactive emissions. Apparently, local and temporal distributions of the radioactive material are different in various organs. In this paper, the effect of radioactive Iodine distribution on the amount of exposure at different distances has been investigated.
This analysis has been carried out using adult NCAT phantoms, Monte-Carlo simulation, and GATE code. By applying the same amount of activity on five different organs of the phantom, the quality and quantity of energy has been computed as well as the amount of emitted exposures at distances of one, two, and three meters. Then, by setting thyroid as the basis, the difference of exposure emitted from other four organs has been calculated and analyzed using KS test.
Findings: Simulation results had been showed that the amounts of exposure that emitted from aforementioned organs are significantly different at the distance of one meter whereas this difference diminishes significantly at distances of two and three meters. In other words, the effect of radioactive Iodine integration location on the emitted exposure is being trivial as the distance increases.
Discussion & Distinct TEDE values must be defined for each of the aforementioned organs and confirmed before releasing patients who will be faced to the others at short distances. Otherwise, guidelines must be considered for the others who will be faced to the released patient.

Candidal vulvovaginitis occurs in female genital by the over growth of candida especially candida albicans. This infection may be resistant to therapy and occasionally becomes chronic. In some patients this form of infection is recurrent. Candida species are the most important factors in development of fungal infection in human beings and animals. According to the daily increase of drug resistance, attempts are important for providing anti-fungal and anti-microbial drugs. With the increasing consumption of medical plants for medical treatment, this topic of complementary medicine found a unique place. This study compares the concentration effects of Cichorium intybusL. and Matricaria chamomilla L. hydroalcoholic extract and the mixed with Nystatin on the isolated Candida albicans from Vaginal Candidiasis and standard under in vitro conditions.
This experimental study assessed the antifungal effects of two plant extracts on candida albicans. Cichorium intybus L and Matricaria chamomilla L. were selected based on the previous researches and traditional usages. C.Albicans was cultured on sabouraud dexterose agar containing chloramphenicol. On each plate, one plant extract disc, one nystatin disc (as positive control), and one blank disc (as negative controls) were placed. The mean diameter of non-growth halo around each plant extract was compared with the mean diameter of non-growth halo of positive control discs after 24 hours. Data was analysed by ANOVA statistical test (PFindings: There was a significant difference between the diameter of non-growth halo around the plant extracts and Nystatin discs. The diameter of non-growth halo in nystation discs (30 mm) was more than that for Matricaria chamomilla L. discs (21 mm). Non-growth halo in discs (28 mm) nystation were also more than Cichorium intybus L. discs (17 mm) (pDiscussion & Cichorium intybusL and Matricaria chamomilla L. exhibited antifungal effects on C. Albincans But the effect of Matricaria chamomilla L. on the lack of growth of Candida Albicans strains was greater than that in Cichorium intybusL.

Muscle imbalance of the upper quadrant of the body is one of the problems in paraplegia spinal cord injury (SCI) patients using wheelchair. This increases the risk of developing deformities and exposes the person to upper cross syndrome (UCS). The use of NASM-based corrective exercises is one of the new ways of restoring muscle balance for preventing and correcting deformities. The aim of this study was investigating the effect of NASM-based training protocol on UCS in paraplegia SCI patients. 22 male paraplegic spinal cord injury patients with forward head, round shoulder, and kyphosis deformities were selected and divided into two groups of training(n:12, age:38.68±9.81) and control(n:10, age:40.40±7.33). Training group performed NASM-based exercises for 12 weeks. Goniometer, double square, and flexible ruler were used to measure forward head, round shoulder, and kyphosis, respectively. The statistical analysis of variance for repeated data at the significance level of (P <0.05) was used to analyze the data. Forward head, round shoulder, and kyphosis deformities had significant improvements in training group in comparison to control group from pre to post test(P <0.05). It is suggested that people with SCI who spend a lot of hours on the wheelchair should modify the position of the nose using the proposed NASM-based training exercises in this study on a regular basis in order to prevent muscle imbalance and developing the deformities in the upper quadrant of the body.

Risk behaviors contribute to leading causes of death and reduced quality of life among adolescents and youth. The purpose of this study was to investigate the factor structure, validity, and reliability of the checklist of risk behaviours for youth (CORBY).
The research was descriptive. A sample of 533 middle school and high school students were selected with multistage cluster sampling of students of Tehran. To calculate the convergent and divergent validity, Children’s Depression Inventory, Oxford Happiness Questionnaire, and Catastrophic Cognitions Questionnaire were used. In order to assess the first order confirmatory factor of the risk behaviors for youth (CORBY), the weighted lowest squares (WLS) and to assess the adequacy of the model to the data, the parameters of RMR ¡­RMSEA ¡­CFI ¡­AGFI ¡­GFI ¡x2¡ x2/ df were used. Data analysis was conducted by SPSS.16 and Lisrel 8.80.
Findings: The average score for boys in all three levels of high-risk behavior is higher compared with an average score of girls. Factor structure of the CORBY was confirmed with using confirmatory factor analysis. Correlation analysis showed that the CORBY with Children's Depression Inventory (PDiscussion & First-order factor structure of the three-factor “CORBY “showed better fitness with the observed data. Based on the findings, the checklist of risk behaviours for youth has acceptable psychometric properties.

Salmonella is one of the most important food-borne pathogens and zoonotic agents all over the world. Antibiotic resistance is a growing problem in Salmonella isolates and spreading of resistance genes by integrons to susceptible strains is one of the major concerns in the emergence of resistant strains. The aim of the current study was the identification of classes of integrons in the Salmonella infants isolated from clinical samples and their antibiotic resistance profile.
Material & In the cross-sectional study, 101 salmonella isolates were obtained from the stool samples. The antibiotic susceptibility test was determined using the disk diffusion method agreeing with CLSI guideline. Cellular DNA was extracted by AccuPrep Genomic DNA Extraction Kit and MPCR was performed for the identification of the intI, intII and intIII genes.
Findings: Sixty S. infantis isolates were collected using biochemical and microbiological tests. The lowest resistance rate in all isolates was related to Ceftriaxone (45%). The molecular analysis of classes of integrons showed 59 (98.3%), 51 (85%) and 23 (38.3%) isolates caring intI, intII and intIII genes, respectively.
Discussion & The result of this study showed that due to increased level of drug resistance in S. infantis and the presence of class 1 integron in these strains, resistance can be transferred to other food borne pathogens.

Exposure to estrogen like chemicals during critical periods of development particularly in the neonatal period can disrupt normal patterns of mammary tissue development later in life. In this study, the effects of neonatal exposure of tamoxifen anti-estrogen and zearalenone mycoestrogen on some histological characteristics of mammary gland in female mouse were investigated.
Twenty newborn female mice of BALB/c strain were divided into four groups: three experimental and one control group (with no treatment). Treatment groups included Tamoxifen (400 μg /kg /day) group, Zearalenone treatment group (2 mg /kg /day) and group treated with tamoxifen췦꭪垧ꉷ treatment group. Daily treatments were started on the first day of life and continued up to 5 subcutaneously. Then about 70 days after birth, mice were deeply anesthetized and the mammary tissue was removed from the body. Following histochemical staining, the samples were studied using light and transmission electron microcopies.
Findings: The result showed that epithelial thickness of milk duct and volume of the nipple in tamoxifen treatment group significantly (pDiscusion & The results of this study show that neonatal administration of tamoxifen probably exerts anti-estrogenic effects and it prevents the normal development of mammary tissue, but zearalenone do not have adverse consequences on mammary tissue.

To determine fertility influential factors, demographical researchers study influential economical, social and cultural elements. The aim of this article is to apply Poisson regression model to investigate influential factors on children ever born, one of the fertility determinant indices, of migrant women to Tehran according to 2011 Population and Housing Census.
From 2011 Population and Housing Census data, 33420 ever married migrant women to Tehran were selected. Poisson regression model of these women's children ever born according to predictors of age, educational level, job status, internet use, and migration cause has been fitted by SPSS 22.
Findings: All of the predictors (age, P-valueDiscussion & The results of fitted Poisson regression showed that women in older age groups with lower educational level, unemployed, and those who didn’t use internet and their cause of the migration was following family had greater mean of children ever born. According to the results, it can be concluded that the possibility of increasing children ever born of women in younger ages, with higher education and employed could be existed by applying correct fertility policies.

Invasive aspergillosis is the most threatening disease inimmunoco-mpromised patients which has the highest morbidity and mortality rate among invasive fungal infections in the hospitals. The aim of present study was to assess antifungal susceptibilitytesting versus Aspergillus spp isolated from the hospitals environment.
After collecting 160 plates containing Sabouraud dextrose agar from the air and the environment of hospital's ICUs (intensive care units), the phenotypic and molecular identification of the colonies was performed for the identification of Aspergillusspp. After DNA extraction, the molecular identification was carried out using universal fungal primers (ITS gene) and DNA sequencing. Antifungal susceptibility testing was performed using the CLSI broth microdilution (M38-A2) method for Aspergillus isolates.
Findings: Out of 160 hospital environmental samples, 11Aspergillus species were obtained. The eleven Aspergillus spp. were identified by sequencing as: 5 A. flavus, 3 A. sydowii, 1 A. fumigates and 2A. Oryzae. Our antifungal susceptibility testing results indicated that A. sydowii and A. fumigatus were sensitive to Amphotericin and Voriconazole and also were resistant to Itraconazole. A. sydowii was resistant to Caspofungin while A.fumigatus was sensitive to this drug. A. flavus was susceptible to all the drugs.
Discussion & There were a number of reasons including delayed diagnosis, lack of appropriate curing, and the existence of various diseases and neutropenia which could lead to the high mortality rate of patients with Aspergillosis, especially in patients of hospital's ICUs.

Neospora caninum is an intracellular protozoan considered as a serious disease agent in cattle and dogs. In the present study, N. caninum tachyzoites were cultivated in mouse macrophage cell line and Vero cell line.
The number of harvested tachyzoites was recorded daily. After parasite propagation and continuous passages, chicken embryonated eggs were used for comparison of tachyzoites attenuation. Mortality rate was recorded daily and the tissue samples of brain, liver, and heart were taken for histopathological examination.
Findings: Mortality rate in embryonated eggs inoculated with N. caninum harvested from Vero and mouse macrophage cell line was 100% and 10%, respectively, which was dose-dependent. Microscopically, there were milder hepatitis and myocarditis in the liver and heart of chickens inoculated with N. caninum harvested from mouse macrophage cell line.
Discussion & The present findings showed that cultivation of N. caninum tachyzoites in macrophage cell line increased propagation of tachyzoites and also reduced attenuation of the parasite. These results suggested the suitable cell line for mass production of N. caninum tachyzoites for various experimental researches and also producing live attenuated vaccine.

Industrial progress, development plans, and infrastructure projects, despite all the benefits and benefits that human beings have had, have been a source of fatalities, risks, and significant failures. Risk Assessment an organized and systematic approach to hazard identification and risk assessment for ranking decisions in order to reduce risk is partially acceptable. The purpose of this study was to identify the hazards in the Ilam gas refinery using William Fein method which is a quantitative method.
Material & This descriptive-analytic epidemiologic study was conducted in Ilam gas refinery in 2012. The sample consisted of 9 units from 18 units of Ilam gas refinery which were randomly selected. In order to identify the risks, a team of representatives from the departments and departments of the present project conducted the projrect. In this document, the HSE-FO-001 (0) -90 hazard identification and risk assessment was also documented in units. This method evaluates and calculates the risks using the severity of the outcome, the probability of occurrence, and the exposure level.
Findings: In this study, 289 risks were identified, of which 5 (0.73%) risks at emergency level (urgent need for corrective actions), 40 risks (13.84%) at abnormal level (requiring consideration and attention Faster) and 244 risks (84.43%) at the level of natural risk (to be eliminated).
Discussion & The major dangers that threaten employees at the Ilam gas refinery are the risks of work at height and inhalation of sour gas containing hydrogen sulfide. Therefore, it is better to apply engineering measures in different units of the refinery to reduce the level of risk.

There is much evidence to show that separation anxiety can also occur in adults. The aim of current study was to examine the psychometric properties of adult separation anxiety questionnaire made by Manicavasagar , Silove ,Wagner and Drobny2003 (ASA -27).
400 students of Semnan University were selected by multistage cluster sampling method; they responded to the instruments of the study including adult separation anxiety questionnaire, Structured Clinical Interview for separation anxiety syndrome Adults and Separation Anxiety Symptom Inventory. Factor analysis, Cronbach's alpha coefficients and Pearson correlations methods were used for data analysis.
Findings: Factor analysis and convergent validity methods were used to determine the construct validity of adult separation anxiety questionnaire (ASA-27). Results from factor analysis showed the adult separation anxiety questionnaire measure own factor. Result from Factor analysis showed that 5 questions (questions 1, 3, 13, 19 and 26) on adult separation anxiety factor loadings were less than 30/0; therefore they were excluded from the questionnaire. Also, results from convergent validity indicated a significant relationship between adult separation anxiety and symptoms of separation anxiety in childhood and adult separation anxiety symptoms in a structured clinical interview, there was a significant relationship. Reliability of the adult separation anxiety questionnaire (ASA-27) by Cronbach's alpha coefficient was 0/89. The correlation between the two questionnaires (SCI- SAS) and (SASI) was 0/651(p Discussion & Persian version of adult separation anxiety questionnaire in students is of a good validity and reliability and it is an appropriate and practical instrument for the measurement of diagnosis of separation anxiety in adults.

The observance of human rights requirements as a general rule in concluding international agreements, such as the WTO agreements, is necessary and, accordingly, a commitment to guarantee the right to access basic medicines as one of the titles and examples of the right to health, which has a meaningful relationship. It also has the right to live which is inevitable for governments.
The present study uses a descriptive-analytical method to determine the provisions of the International Covenant on Economic, Social, and Cultural Rights on the Right to Access to Essential Medicines as Human Rights, which can be considered as one of the examples of support for pharmaceutical innovations. The patent that is protected by the World Trade Organization's Trips agreement as a trade-mark of intellectual property rights is protected by the definition of private law.
Findings: Based on the provisions of the Trips Agreement on Patents, including Articles 27 and 28, the holder holds the exclusive intellectual property right to manufacture, use, supply for sale, and sale or import, which can challenge the access to medicines. The underlying cause and the increase in the cost of such drugs, and this in particular, makes it difficult for developed and less developed countries to respect the commitment to support and enforce access to essential medicines.
Discussion & In addition to the provisions of the Trips Agreement on limited exceptions and compulsory licenses, the approval of the Doha Summit Declaration on the Trips and Public Health Agreements, as well as the issuance of the Trips Council Decision on the implementation of the provisions of paragraph 6 of this Declaration, are considered as solutions. It has been considered that this Declaration has actually resolved the conflict between the provisions of this agreement and the human rights requirements.

Acceptance and Commitment Therapy is one of the third wave behavioral therapies about anxiety Disorders. The purpose of the present study was to investigate the effectiveness of Acceptance & Commitment Therapy on Generalized Anxiety Disorder in Children with Type 1 Diabetes
This research was conducted with semi-experimental method by pretest-posttest and follow up, including control group. Statistical society of current study was all Children with Type 1 Diabetes referred to diabetes treatment centers in Najafabad town in 2014-2015. Two of these treatment centers were selected by available sampling method. Instrument used in this study was “Screen for child anxiety related disorders” (SCARED). All children filled measure of anxiety and among them, 24 children who were suffering from anxiety were selected and then assigned randomly into two experimental and control groups (n1=n2=12). For subjects in the experimental group 8 sessions of Acceptance & Commitment Therapy, each lasting for 120 minutes, were offered and control subjects received no therapy in this while. Six month later follow up was executed. The data was analyzed by Analyze of Covariance Method ANCOVA(.
Findings: findings showed that mean score of generalized anxiety in children in post-test and follow-up in compare with pretest had a significant decline. By controlling pretest scores, Acceptance & Commitment therapy caused a significant decrease in generalized anxiety scores of children suffering from diabetes type 1, in post-test (F=38.59, P≤0.0001) and also caused significant decrease in anxiety of children, at the end of 6 month follow-up period (F=8.47, P≤0.008).
Discussion & Results indicated that Acceptance & Commitment Therapy was effective on reducing generalized anxiety of children suffering with diabetes type 1 and suggested a persistent recovery on symptoms in follow up. Based on these findings Acceptance & Commitment Therapy can be used for reducing Generalized Anxiety Disorder in children with type 1diabetes. Findings were discussed considering intermediate role of anxiety disorders on glycemic control in diabetic patients.

Angiogenesis is a complex process. In fact, it is one of the most important biological events that can be observed with the production of new vessels in many stages of embryonic development and pathological conditions. In pathological conditions such as tumor growth, the progression of the disease is associated with angiogenesis. Therefore, in the present study, the effects of various doses of zinc oxide nanoparticles on chick chorioallantoic membrane (CAM) were assessed.
In this experimental study, 40 ROSS egg were randomly divided into four groups (controls-group 1-group 2-group 3). After the second day of incubation, a window was opened on the eggs and on the eighth day a gelatin sponge was placed on the chick chorioallantoic membrane. Experimental groups were treated with 500, 1000 and 2000 μg / ml zinc oxide nanoparticles, respectively. On the twelfth day after the incubation, samples were removed from the device and after removing the windows, all of them were viewed using a photo stereomicroscope.
Findings: The results showed that zinc oxide nanoparticles significantly reduced the number and length of blood vessels compared to the control sample (P Discussion & The results of this study showed that zinc oxide nanoparticles have anti- angiogenesis activity in an in vivo environment. In vivo studies showed that treatment with this nanoparticle inhibited angiogenesis would reduce the number and length of chick chorioallantoic membrane vein.