Shiraz Emedical Journal
Volume:18 Issue: 10, Oct 2017

Many health issues have their roots in social aspects of everyday life. In this regard, health should be considered not only a biological matter but also more importantly a social subject. In this study, we reviewed important aspects that should be acknowledged by health system in achieving health equity, considering social determinants of health (SDH). Google Scholar was searched with relevant key words. We also reviewed the documents of world health organization (WHO) relevant to SDH and health equity. Finally, based on this review, we have presented the measures that should be taken by health system to achieve health equity.

Many surgeons have been encouraged to use a variety of incisions for abdominal visceral surgery that are hidden from exposure. The current researchers conducted this study to find the safety and feasibility of open appendectomy using Small Access (SA) incision and compare this method with the classic McBurney’s appendectomy (CA).
Sixty-nine patients with the diagnosis of acute appendicitis at Besat hospital, Hamadan University of Medical Sciences, Iran, during year 2016, were enrolled in the study and were randomly allocated to 2 groups, including SA (n = 39) and CA groups (n = 30). All patients were visited 1 week and 6 months after the surgery.
The demographic data of the patients, including gender and age, was not significantly different between the 2 groups (P values = 0.12 and 0.87, respectively). In 6 patients in the SA group, the incision was transversely extended during the operation. There was no significant difference between postoperative complications in the 2 groups. The amount of pain medication administered during the hospital stay in the SA group was significantly lower than the CA group (110 ± 29.2 mg vs. 134 ± 29.7 mg, P = 0.002). The median satisfaction score of patients with their appendectomy scars was 5 out of 5 in the SA group, being significantly higher than the CA group with median satisfaction score of 3 out of 5 (P Open appendectomy using small access incision may be a safe, feasible, and cosmetically pleasing method in adults and pediatric patients.

Restless legs syndrome (RLS) is a type of movement disorder with strong importunate movement of legs during rest or inactivity. Twitching of muscle is experienced at night that disturbs patients’ sleep. This syndrome is more prevalent among patients with multiple sclerosis (MS). Hence, this study aimed to investigate the association between restless legs syndrome and sleep disturbances in patients suffering from MS.
This cross-sectional study was conducted from May to September 2016 in Qazvin, Iran. Participants were 118 patients with MS referring to the multiple sclerosis association. Data were collected using a demographic questionnaire, expanded disability status scale (EDSS) to screen and assess the intensity of restless legs syndrome, and Pittsburgh sleep quality index to investigate sleep disturbance. Descriptive and inferential statistics including independent T test, 2 test, and stepwise logistic regression analysis were used for data analysis.
RLS was diagnosed in 56.8% of the participants. The score of sleep quality was above 6 indicating poor sleep quality in the patients. However, the mean score of PSQI was significantly higher in patients suffering from restless legs syndrome compared to the healthy people (14.43 ± 2.2 and 11.43 ± 2.2, respectively; P RLS is a prevalent disorder in MS patients leading to sleep disturbances. Therefore, the assessment, diagnosis, and implementation of appropriate interventions to improve patients’ sleep quality are required. Such interventions also can improve patients’ health status and quality of life.

The annual increase in the prevalence of obesity around the world highlights the importance of comorbidities. Along with hormonal changes induced by increased body mass index (BMI), age at menopause might also affect female’s health profoundly. Thus, the present study aimed at studying the association between obesity and overweightness on age of menopause in females.
In this study, patients, who were referred to the obesity clinic of Rasoule-Akram hospital, during years 2011 and 2013 were recruited and the required information were extracted from the center’s database. Inclusion criteria consisted of high BMI, no history of hysterectomy, genital tract cancer, no history of radiation to the abdomen or pelvis, and no primary amenorrhea. For analysis, analysis of variance (ANOVA) and Scheffe’s post hoc test for multiple comparisons considering α of 0.05 for significance level were used and all data were analyzed by the SPSS version 22 software.
The mean age of menopause was 51.6 ± 6 years and the majority of obese females had normal menopause age (57.6%). There was no significant association between the patients BMI and age of menopause and it seems that obesity and overweightness had no effect on age of menopause (P = 0.2).
It seems that overweightness or obesity was not associated with age of menopause, so it could not be said that females, who were overweight or obese compared to normal-weight females had earlier or later menopause.

As crisis caused by cancer results in imbalances and inconsistencies in body and mind as well as many psychological problems in patient’s life, spiritual intelligence is a critical source to increase resistance to the disease. This study aimed to investigate the relationship between spiritual intelligence and psychological well-being in women with breast cancer in Babol.
This descriptive-correlational study was conducted in the spring 2016 on 90 women with breast cancer referring for treatment to Shahid Rajaei hospital of Babolsar, and Ayatollah Rouhani and the counseling center for cancer registry of Babol. Demographic characteristics of patients such as age, marital status, education, occupation, place of residence (urban or rural), and duration of illness were recoded. In addition, two questionnaires of spiritual intelligence self-report inventory (SISRI-24) and Brief Reef Well-Being (18 questions) were used.
The results showed that the mean score of spiritual intelligence was 69.90 ± 14.13 (range of 0 - 98) and the mean score of psychological well-being was 75.01 ± 12.10 (range of 1 - 108). There was a significant relationship between spiritual intelligence and psychological well-being (r = 0.47). The results of multiple regression analysis showed that spiritual intelligence predicted 22% of variance of psychological well-being. Among the demographic characteristics, only the relationship between education and psychological well-being was significant (r = 0.2). Based on the results of backward regression analysis, demographic variables were excluded from the model due to the lack of statistically significant relationship with psychological well-being, and only spiritual intelligence variable (B = 0.41) was identified as the strong independent predictor of psychological well-being of cancer patients in the final model.
It is recommended for cancer treatment and cancer support centers to improve the skills of spiritual intelligence in women with breast cancer, especially in terms of personal meaning production, to promote psychological well-being.