فهرست مطالب ابوالفضل پاینده

Diabetes self-care leads to blood sugar control in diabetic patients. Adherence to medication is one of the methods of self-care. This research to improving medication adherence in type 2 diabetic patients in Zahedan based on the Health Action Process Approach model.

In this intervention study, 210 type 2 diabetic patients referred to diabetes clinics in Zahedan city in two intervention groups (105) and control group (105) were selected from the diabetes clinics of Zahedan hospitals during June and September in 2022. Sampling was done by available methods among diabetic patients. After collecting the data, a pre-test was conducted using the medication adherence questionnaire and the model constructs questionnaire. CVI = 0.7, CVR = 0.6 and Cronbach's alpha of the questionnaire was 0.97. One and three months after the educational intervention, the questionnaire on model structures and self-care behavior was completed by the patients and collected for analysis. Data were analyzed using independent t, Chi-square, and Shapiro-Wilk tests in SPSS version 23. A significance level of 0.05 was considered.

The results showed that all the Health Action Process Approach model constructs including risk perception, outcome expectancies, behavioral intention, action self-efficacy, coping self-efficacy, recovery self-efficacy, action planning and coping planning, perceived barriers, perceived benefits, and self-care behavior had significant differences in one month and three months after the educational intervention (P<0.05), which indicated the effectiveness of the education in the intervention group. However, no significant difference was observed in the control group (P < 0.05).

The intervention with the Health Action Process Approach model showed that the structures of the model after the training had a significant impact on the self-care of patients in the field of medication compliance. Appropriate programs with details in the field of automatic coping self-efficacy and action planning should be designed to promote medication adherence among patients with type 2 diabetes.

Background and Aim:

 Cardiovascular complications in diabetes mellitus are one of the most common complications of this disease. The aim of this study was to determine the cumulative probability of occurrence of cardiac complications in type 2 diabetes mellitus using survival analysis in patients referring to the Diabetes Clinic, Bu-Ali Hospital, Zahedan, Iran.

This was a descriptive and analytical historical cohort study using the survival analysis method in 2020 on 410 patients referring to the Diabetes Clinic, Bu-Ali Hospital, Zahedan, Iran. Data were collected and analyzed using the SPSS-v21 software, the statistical tests being descriptive tests, followed by the Kaplan-Meier method and the Cox proportional hazards model of survival.

The results of this study showed that 122 individuals (29.7%) of the diabetic patients had cardiac complications. The median survival time (in months) of the occurrence of cardiac complications was found to be related to fasting and two-hour postprandial blood sugar levels (p<0.05). Further analysis of the data showed that two variables, namely fasting blood sugar and regular visits, remained in the final model of the multiple Cox regression.

The findings of this study showed that the cardiac complications of diabetes in the population studies are relatively high. Therefore, it is essential to plan and implement interventions aiming to change lifestyle and control regularly blood pressure, cholesterol and blood sugar in the patients in order to prevent the disease

Policymakers can enhance personnel performance and consequently, improve the quality of healthcare by evaluation of suitable leadership styles for health organizations and establishment of effective team groups. This study aimed to determine the relationship between the leadership styles of nursing managers and the teamwork of nurses.

This descriptive-analytic study was conducted among 500 nurses working in eight selected university hospitals in Mashhad and Zahedan, Iran (2022). Data were collected using two standard questionnaires on leadership styles and teamwork through interviews. Descriptive statistical methods, such as the mean and standard deviation, were employed to determine leadership style and teamwork scores. Additionally, Pearson's and Spearman's correlation coefficients were used to investigate the relationship between these two variables.

The dominant leadership style among the participants was transformational leadership (37.6%). The overall mean teamwork score was 3.66±0.48, with 91.8% of nurses scoring teamwork 3 or higher. Transformational and passive leadership styles exhibited the highest and lowest relationships with teamwork, respectively (P<0.05). Additionally, the mean teamwork score among nurses with managers exhibiting a transformational leadership style was higher, compared to other styles (P<0.05).

Managers and executive supervisors can positively impact teamwork and consequently, the performance indicators of their unit by adopting a transformational leadership style and enhancing their leadership knowledge. To achieve this goal, it is suggested to conduct in-service training courses. Additionally, selecting supervisors of centers who promote teamwork and designing a mechanism to collect feedback from hospital personnel regarding the leadership style of their direct managers are recommended.

Diabetes is a common disease that causes eye complications and leads to vision loss and blindness. Diabetic retinopathy is one of the main causes of blindness in the world and the most common cause of new cases of blindness. Predicting the occurrence time of this complication in diabetic people is one of the health priorities of society. The purpose of this study was to determine the cumulative probability of the occurrence of type II diabetes retinopathy using survival analysis in Zahedan City, Iran.

This was a historical cohort study using the survival analysis method, which was carried out descriptively and analytically on 410 patients in 2019. Data were calculated using SPSS22 software and descriptive tests, followed by the Kaplan-Meier method and the Cox proportional hazards model of survival.

The results of this study showed that 103 (25.13%) patients had retinopathy. The median survival time (months) of the occurrence of cardiac complications was related to marital status, fasting blood sugar, smoking, hemoglobin A1c, and blood lipids (P<0.05). The variables of fasting blood sugar, A1c, and two-hour blood glucose remained in the final model of the multiple Cox regression.

The findings of the current research showed that the prevalence of retinopathy in the studied population was relatively high and had a significant effect on reducing survival time. Therefore, it is necessary to make interventions in lifestyle changes, and regular control of blood pressure, cholesterol, and blood sugar to prevent the disease and reduce complications related to diabetes

Infective endocarditis is a rare condition that occurs in susceptible patients following invasive dental treatments. In order to prevent this complication, it is recommended to prescribe antibiotics for susceptible patients before performing some dental procedures. Therefore, the present study aims to survey the level of knowledge of students of the last three years of Zahedan Faculty of Dentistry about modern antibiotic prophylaxis regimens in various dental treatments was carried out in 2022.

The current study is a cross-sectional observation (descriptive-analytical) and included 96 dental students of the last three years of Zahedan Medical Sciences in 2022. The data were collected using a questionnaire and entered into 24spss software for analysis. The chi-square test or Fisher's exact test was used to compare the frequency between groups (checking the assumption of independence).
 

According to the findings of the present study, 74% of the 96 people participating in the study had good knowledge about the new prophylactic antibiotic regimens in various dental treatments. In the final year of Zahedan dentistry, there was no statistically significant difference between women and men regarding modern antibiotic prophylaxis regimens (p=0.55). Also, there was a significant difference in the frequency of knowledge of Zahedan dentistry students in the last three years (p˂0.001).

The results of the present study showed that the students had good knowledge about the new prophylactic antibiotic regimens in various dental treatments.

For many years, hysterosalpingography was considered as the gold standard for the diagnosis of uterine cavity abnormalities, and today, hysteroscopy has been proposed as a complementary method. The present study was conducted with aim to investigate the accuracy of findings of undiagnosed filling defects in hysterosalpingography by hysteroscopy in infertile women.

This cross-sectional (descriptive-analytical) study was conducted in 2020-2021 on 107 infertile women referred to Ali Ibn Abi Talib (AS) Hospital of Zahedan. Hysterosalpingography was performed for women and they had undiagnosed filling defects. After performing hysteroscopy, a questionnaire was recorded for each patient including: patient's age, age of infertility, type of infertility and hysteroscopy findings. Data were analyzed by SPSS software (version 24) and chi-square, Fisher, and Binomial tests. P<0.05 was considered statistically significant.

64 patients (59.81%) had primary infertility and 43 (40.18%) had secondary infertility. The most pathological finding in hysteroscopy was polyp that was observed in 34 patients (31.77%) which were most frequent in the age range of 35-40 years. Also, 80 patients (74.76%) had abnormal hysteroscopy findings and 27 (23.25%) had normal findings. According to the Binomial test, there was a statistically significant difference between the percentage of normal findings between hysteroscopy results and filling defects without hysterosalpingography (P<0.001).

Hysterosalpingography is a simple method for diagnosing abnormalities of the female reproductive system, but it is less sensitive than hysteroscopy. Therefore, hysteroscopy can help for more accurate and better diagnosis in examining the condition of patients with infertility.

Diabetes is one of the chronic diseases and the most common disease related to metabolism in humans. Diabetic nephropathy, one of the dangerous complications of diabetes, has a relatively high prevalence in diabetic patients and causes kidney failure. Several factors have an effect on this disorder. The aim of this study was to determine the cumulative probability of occurrence of nephropathy complication of type 2 diabetes using survival analysis.

This study was a historical cohort study of survival analysis, which was conducted in a descriptive-analytical manner in 2019. The required sample size was estimated at 410 patients. Data were calculated using Stata.ver14 software and descriptive tests and then by Kaplan Meyer method and Cox survival proportional hazards model.

The variables of regular visits and smoking showed a significant relationship with the chance of nephropathy complications (p<0.05). Therefore, the chance of nephropathy complications in people who did not have regular visits was 1.03 times that of people who had regular visits. The Log-Rank test showed that the median survival time (months) of the occurrence of nephropathy is related to the variables of fasting blood sugar, blood pressure, systolic, and blood lipids.

With early diagnosis of diabetes and control of the factors that accelerate the development of diabetic nephropathy and effective and timely treatments, it is possible to reduce the progress of the disease and it can be used in the field of prevention and treatment of diabetic patients and prevention of subsequent lesions and complications.

Hospitals spend about half of the national health expenditures. Some of the costs imposed on hospitals are due to inappropriate admissions that result in a waste of resources. The purpose of this study was to estimate the inappropriate hospital admission rates in southeast of Iran during 2014 to 2019.

A cross-sectional study was conducted in the two largest hospitals of Zahedan University of Medical Sciences (ZAUMS) in 2020. The study population included patients admitted to the internal medicine and surgery wards of two teaching hospitals of which 602 persons were selected through a multi-stage sampling method. Data were collected from medical records using an Appropriate Evaluation Protocol (AEP). SPSS software (v. 24) was used to analyze the data using descriptive statistics, chi-square, and Fisher’s exact tests. P < 0.05 was considered as statistical significance.

The rate of inappropriate admissions in hospitals was 8.3% and inappropriate hospital stay was 3.5%. Also, 12% of laboratory services, physician visits, nursing services and medicine in these hospitals were inappropriate. The results of chi-square test showed that the ratio of inappropriate admissions in both internal medicine and surgery wards were significantly different (P <0.05). Also, there were no any significant relationship between inappropriate admission and hospitals, age groups and gender. 

According to the findings, the rate of inappropriate admissions in hospitals in southern Iran is high. In order to reduce inappropriate admissions, the following suggestion might be recommended: accuracy in hospital triage, full use of referral system, and employment of specialized physicians in public hospitals.

Unhealthy nutrition is a risk factor for cardiovascular disease. This study aimed to determine the effect of an educational intervention based on the theory of planned behavior in promoting the preventive nutritional behaviors of cardiovascular disease.

In this quasi-experimental study 199 women using the multistage sampling method were divided into intervention (n=100) and control (n=99) groups. Data were collected using a researcher-made questionnaire including demographic and specific questions. The validity and reliability of the questionnaire were confirmed. The data using descriptive statistics (mean, standard deviation, frequency, and percentage) and analytic statistics (Independent and paired t-tests, analysis of covariance, and chi-square test) were analyzed and the educational program was designed. Training program including the face-to-face education and distributing the educational message and clips in the experimental group conducted and after two months the data collected again and were analyzed (P≤ 0.05). 

Before the intervention, no significant difference was found between the two groups in terms of demographic variables, Attitude, Perceived behavioral control, behavioral intention, and behavior. After the intervention, the mean scores of the attitude, subjective norms, perceived behavior control, and intention in the experimental group meaningfully were increased (P ≤ 0.05).

Educational intervention based on the theory of planned behavior promotes the preventive nutritional behaviors of cardiovascular disease in women

The prevalence of asthma has increased dramatically among children. The aim of the study was to determine the prevalence of asthma symptoms among school‐age children in Zahedan, southeast of Iran.

In this cross-sectional study, 1,600 primary school girls and boys were examined by multistage random sampling. Data were collected using the International ISAAC Questionnaire. The data were analyzed in Stata.14 software using chi-square test, multiple logistic regression and Kappa coefficient.

The prevalence of asthma based on physician diagnosis was 6.2%. The prevalence of asthma was statistically significant in girls with 8.3% and boys with 4.2% (P

AFP (Atypical Facial Pain) is indicated as a pain sensation of oral mucosa without any visable mucosal lesions during clinical examination. The aim of this study was to evaluate of oral health related quality of life among patients with Atipical Facial pain,referred to Zahedan dental school and compare it with healthy people.

This cross-sectional study was performed on 48 AFP patients at Zahedan dental school and 96 healthy people. collection method was General Oral Health Assessment Index (GOHAI) questionnaire and demographic data. questionaire included 12 questions about oral health-related quality of life with 5 options.the data was analysed in spss software.

In case group 31.9% (15 people) of the patients were men and 68.1% (32 people) were women, and in control group 36.1% (35 people) of the patients were men and 63.9% (62 people) were women. the mean score of GOHAI in patients was 27.85±10.68 and in control group was 45.49±6.84 which indicators that the mean of oral health related quality of life between the two groups was statistically significant (P<0.001).

The results of this study showed that oral health-related quality of life in AFP patients is weaker than healthy people wich indicates that need for care to maintain of oral health of individuals who are Atipical Facial Pain.

Genetic and environmental factors are known to be related to the development of childhood Eczema. We aimed to assess the ecological factors associated with the prevalence of Eczema among children using the ISAAC questionnaire.

A total of 1600 primary school girls and boys were selected and examined by multistage random sampling in this cross-sectional study. Data were collected and completed using the International ISAAC Questionnaire, including demographic questions and risk factors through interviews with parents, especially the student’s mother. The data were analyzed in SPSS v. 19 software using the Chi-square test and multiple logistic regression.

This study was approved by the Ethics Committee of Zahedan University of Medical Sciences (Code: REC.1397.481).

 The prevalence of current Eczema was 10.4% (95%CI: 8.9-11.9). Co-morbidity with Asthma and Rhinitis was 82.8% and 74.5%, respectively. In multiple logistic regression models, history of allergies in family members (OR: 2.35, 95%CI: 1.53-3.59), father snoring (OR: 3.00, CI95%: 1.98-4.55), Keeping any animal in (OR: 1.6, 95%CI: 1.002-2.58), family size (OR: 0.85, 95%CI: 0.68-0.95), exposure to tobacco smoke at home (OR: 2.84, 95%CI: 1.18-6.81), showed a significant relationship with the occurrence of students’ Eczema.

 Exposure to tobacco smoke at home, keeping any animal at home are effective factors in the prevalence of Eczema in children. By eliminating these factors, the prevalence of this disease can be reduced. However, the mothers have the most crucial role in screening and early diagnosis of Eczema in school children regarding determinants in this study. According to the results of this study, it is suggested that parents’ education, especially mothers, be emphasized by paying attention to these favorable factors.

Retinal nerve fiber layer thickness is an important factor in the early diagnosis of posterior pole dysfunctions, assessment of treatment effect, and disease progression. The aim of this study was to compare the macular and peripapillary retinal thickness between genders and among refractive error types in healthy subjects. In addition, effective determinants of the thickness were ascertained.

This cross-sectional study was conducted on 58 subjects (116 eyes) who were referred to the Toos eye clinic of Mashhad, northeast of Iran, for refractive error surgery and their caregivers in 2014. We used Optical Coherence Tomography for retinal thickness measurements.

The mean age was 26.02±0.42 years. The mean±SD spherical equivalence was estimated to be -2.06 ± 0.36 dioptres, axial length was 23.89 ± 0.14 mm, average peripapillary thickness was 89.91 ± 0.94 μm, average macular thickness was 274.68 ± 1.84 μm, and overall macular volume was 9.89 ± 0.07 mm3. Multiple linear regression modeling indicated that axial length and gender had a significant effect on average macular thickness. Axial length also showed a substantial effect on average peripapillary thickness.

Retinal thickness measurement regardless of refractive error type could lead to bias in disease diagnosis. The results of the present study might be used to enhance the assessment precision of ocular diseases.

The prevalence of Allergy Rhinitis (AR) has increased dramatically among children. The aim of this study was to determine the prevalence of AR symptoms among school‐age children in Zahedan, southeast of Iran.

In this cross-sectional study, 1600 primary school girls and boys were selected and examined by multistage random sampling. Data were collected and completed using the International ISAAC (International Study of Asthma and Allergies in Childhood) questionnaire including demographic questions and risk factors through interviews with parents, especially the studentchr('39')s mother. The data were analyzed in SPSS19 software using chi-square test and multiple logistic regression.

The prevalence of current AR and Rhinoconjunctivitis among elementary school Children was 15.3% and 10.2% respectively. The prevalence of current AR was not statistically significant in girls with 14.2% and boys with 16.4% (p>0.05). Co-morbidity with asthma and eczema was 27.3% and 28%, respectively. The occurrence of AR was related to BMI, family size, snoring father, type of heating and cooking (p<0.05).

The prevalence of AR in Zahedan is relatively high due to the special climatic conditions and geographical climate of the region. Overweight in students and the use of fire for cooking and heating the house is an effective factor in the prevalence of AR in children, which can be eliminated by reducing the prevalence of this disease. However, the mothers have most important role in screening and early diagnosis of AR in school children regarding determinants in this study.

In addition to effective treatment, tuberculosis recurrence is a very important challenge regarding the treatment of this infection. This study was conducted to evaluate the risk factors associated with tuberculosis recurrence.

In this nested case-control study, 202 tuberculosis patients with recurrence and 202 matched controls in terms of age, sex and place of residence were studied. The cases and controls were selected from a cohort of tuberculosis patients in Sistan and Baluchestan province between 2011 and 2018. The data were collected using interviews and patients’ records. The independent t-test, chi-square and multiple conditional logistic regression were used to analyze the data.

The drug abuse history (OR=6.1), 3+ smear positive (OR=3.03), chest X-ray suggestive of tuberculosis (OR=4.9), drug resistance (OR=7.3), low socioeconomic status (OR=3.9), weight loss (OR=3.1), chest pain (OR=3.2), history of digestive disease (OR=22.1), smoking (OR=6.1), and imprisonment (OR=3.7) significantly increased the chance of recurrence among tuberculosis patients (p<0.05). On the other hand, the chance of recurrence was significantly lower in patients with coughs (OR=0.29) and a small family size (OR=0.28).

According to the results, tobacco use, drug use, low socio-economic status, life conditions, and disease conditions are the most important determinants of tuberculosis recurrence. In general, epidemiologic factors related to tuberculosis recurrence are not similar in different regions; therefore, educational programs for patients and their families and prevention methods should be considered based on related factors in different regions.

Atypical Facial Pain (AFP) refers to the sensation of pain in oral mucosa without any visible mucosal lesions and can be diagnosed during a clinical examination. Doctors who are not aware of AFP do not take the symptoms seriously and consider it as an unrealistic feeling. The ignorance of doctors in this regard increases anxiety and the sense of pain in patients.

The present study was performed on 47 eligible patients with AFP who were similar to the control group regarding their age and gender. The Holmes-Rahe stress inventory and the complaint registration form were used to collect the required data which were used to compare the frequency of complaints and the type and severity of stressful events. The collected data were analyzed using t-test, chi-square, Mann–Whitney, multiple regression, and logistic tests. Moreover, a p-value of 0.05 was considered statistically significant.

According to the findings, 80.9% of the patients complained of non-dental pain. The results of the Mann-Whitney test revealed no significant difference between the case and control groups regarding the severity of pain (P=0.251). Moreover, the results of the Chi-square test indicated that the duration of pain complaints had a significant difference in the two groups (P=0.004). Furthermore, a comparison of stressful life events revealed that the death of a spouse or a family member, changes in lifestyle (e.g., change of location, activities, diet, sleeping habits, and responsibilities), and changes in living conditions and financial status were the cause of stress in 12.7%, 17.02%, and 14.58% of cases in the control group. In addition, the results of the t-test showed that the level of stress was significantly higher in the case group, compared to the control group (P=0.032).

Based on the findings, there was a significant difference between the patients with AFP and other patients referring to the clinic of Zahedan dental school, regarding the frequency of complaints as well as the type and severity of stressful events.