فهرست مطالب بهزاد بوشهری

Suicide is among the most important indicators of the mental health of the people in a society, which is caused by several factors, and depression is one of the most critical factors related to suicide attempts. Cognitive psychotherapy is one of the effective methods for people with suicidal thoughts, which can be effective on depression symptoms. Therefore, a study aimed to determine the effect of cognitive behavioral therapy on the depression of people attempting to commit suicide who were discharged from medical education centers in Urmia in 2020.

This semi-experimental study was conducted on 60 participants who tried to commit suicide and were discharged from medical centers in Urmia City, Iran, in 2020. With the convenience sampling method, 60 people were selected from the suicide attempters and then randomly and equally assigned to control and intervention groups. The short form of Beck depression questionnaire and demographic questionnaire were used to collect data before the intervention, immediately after the intervention, and three months after the intervention. The training package for the intervention group was held during eight sessions of 60-90 minutes with a frequency of two sessions per week. No intervention was done for the control group. Data collected by SPSS software (22) were analyzed through Chi-square statistical test, Fisher's exact test and Repeated Measure ANOVA.

The results showed that there was a significant difference between the intervention and control groups in the trend of depression scores of the suicide attempters discharged from the treatment centers (P<0.001). The pairwise comparisons based on the Bonferroni test showed no statistically significant difference concerning the depression score of people attempting to commit suicide discharged from medical centers in the control group in the periods before and after the intervention (p=0.001). However, there was a statistically significant difference between the periods before, after, and three months after the intervention in the intervention group (P<0.001).

In this study, the effectiveness of cognitive behavioral therapy was observed in the intervention group, and the symptoms of depression improved significantly. Therefore, it could be concluded that cognitive behavioral therapy may have a significant improvement in reducing suicidal thoughts and despair. In addition, this treatment can positively affect a person's behavior and improve the quality of his/her life. However, more studies are needed to measure the exact effectiveness.

Development of the registry system for substance abuse poisoning may be useful in the systematic collection of information, prevention of poisonings, identification of people and monitoring them, ease of access to information, and decision-making in allocating resources. Evaluation of the usability of information systems is one of the most important ways to improve disease registration programs. The purpose of this study was to evaluate the usability of drug abuse registration system from the users' point of view at Urmia University of Medical Sciences.

This study was a cross-sectional descriptive one conducted in 2022. In this study, the opinions of 21 system users were evaluated. Census sampling method was done from the cases reffered to the Imam Khomeini Educational and Medical Center in Urmia, Iran. Data collection tool was a standard QUIS questionnaire with 32 questions in 6 dimensions including: general interaction with the system, screen, system terms, learning ability, general capabilities of the system, and usability and user interface. The data were analyzed using SPSS version 16 software.

The results showed that the average score obtained in the six dimensions of the usability evaluation of the registry system for substance abuse poisoning were: 8.52 in system terms, 8.36 in screen, 8.28 in learning ability, 8.04 in general capabilities of the system, 7.98 in usability and user interface, and 7.73 in the general interaction, respectively.

From the user's point of view, working with the registry system for substance abuse poisoning is simple and easy to learn, and the screen and system terms are appropriate. However, the users were relatively satisfied with the capabilities of system configuration capabilities and its reports. Therefore, the designed system requires some changes to improve the quality of reports.

Poisoning as an important dilemma of public health. In this study, we investigated the effects of Silymarin on decreasing elevated levels of liver enzymes and early outcome in patients with drug poisoning admitted to the intensive care unit. In this cross-sectional study, 65 patients with poisoning were evaluated during 1394. The patients’ demographic information (age - sex), the initial level of liver enzymes was checked at the time of admission and after taking the drug and also the outcome of the patients was evaluated. Patients with history of alcohol consumption, another co-morbidity such as viral hepatitis and pregnancy were excluded. In the group receiving the drug, ALT was decreased in 24 patients (58. 5%) and was not decreased in 17 patients (41. 5%), compared with the control group, the difference was statistically significant (P = 0. 04). In the intervention group, 21 patients (51. 2%) had recovery in the AST levels, but in 20 (48. 8%) cases, there was no reduction in AST. This difference is significant in comparison with the control group (P = 0. 03). In the control group, AST was decreased in 6 patients (20%), but in 18 (75%) patients no decrease was observed, this difference was significant between the two groups (P=0. 03). There was no significant difference in serum alkaline phosphates between interventio and control groups (P = 0. 26). According to Kaplan-Meier analysis, the patients in the intervention group had a faster recovery in the level of enzymes and have been transmitted to ward or discharged earlier. The present study shows that Silymarin reduces liver enzymes and causes the patients be discharged or transmitted earlier than usual to the ward and can be used in other cases in addition to the current treatment of poisoning.

  Suicide is a major challenge in health of the community, and the rate of suicide is one of the signs of a depressive disorder. On the other hand, there are hypotheses that blood cholesterol levels affect depression, but it is not clear that how much of it is related to suicide attempts. Therefore, the present study was carried out to determine the relationship between serum level of cholesterol and depression in patients referred to the Toxicology Ward of Taleghani University Hospital in Urmia, 2018. This descriptive cross-sectional study was carried out with 180 subjects. The demographic and Beck Depression Inventory and a checklist for controlling serum cholesterol levels were used and data were analyzed by SPSS version18. The prevalence of suicide in females was 54.4% and 45.6% in males, of which 82% were in the 15 to 24 years old age group. About 85.9% of the victims had mild to severe depression and their mean serum cholesterol level was 147 ± 35mg /dl. On the other hand, there was not any relationship between cholesterol level with age, depression, suicide attempt rate, suicide attempts, and suicidal tendency (p ≤ 0.05), but there was a relationship between cholesterol level and suicide rate (p = 0.002). Perhaps blood cholesterol cannot be considered as a definitive cause of depression or suicide. However, consideration of the role of depression as a risk factor for suicide commitment is necessary. In order to prevent this social problem, it is necessary to pay attention to the promotion of mental health and the use of a variety of treatments for mental disorders.

To date, no study with a proper sample size has been done to evaluate the efficiency of using pre-designed checklists in history taking of trauma patients in Iran. Therefore, the present study was designed to evaluate the pre-designed checklist’s effects on the quality of history taking in trauma patients referred to the emergency department (ED).
In the present prospective cross-sectional study, data of the trauma patients presented to the ED were recorded either with or without using a checklist, randomly. The designed checklist consisted of personal data, trauma mechanism, wound characteristics and trauma severity, severity and location of injuries, and the patient’s diagnostic and therapeutic plans. The quality of data gathering in each evaluated item was divided into 3 groups of complete recording, incomplete recording, and not recorded. Data recording quality was compared between the 2 groups using chi square or exact Fisher’s test. In all analyses, p In the preset study, patient data were gathered without using a checklist in 795 and using a checklist in 384 cases. Complete and accurate data recording in all items was more frequent in the group that had used the checklist (p It seems that using pre-designed checklists for history taking in trauma patients, leads to a significant increase in quality of data recording and history taking.

Medical profile is an important source of data regarding the patient, the illness, the doctor’s performance and leads to adequate diagnosis and treatment. Filling out medical profiles correctly, greatly decreases medical errors and leads to accurate diagnosis and proper treatment of the patients. This study aims to evaluate the quality of the patient records of trauma patients admitted to the emergency department of Emam Khomeini Hospital, Urmia, Iran.
In a cross-sectional study, the medical profiles of trauma patients admitted to the emergency department of Emam Khomeini Hospital, Urmia, Iran in November 2013 were evaluated aiming to determine the quality of filling the profiles. All the patients’ medical profiles were evaluated regarding accurate recording of trauma mechanism; size, site of injuries; vital signs recordings; diagnostic and treatment plan. Based on the Likert scale, the quality of data recording was rated as: not recorded, recorded with high quality, recorded with low quality. The data were statistically analyzed using SPSS 21.
In this study, 795 profiles were studied and evaluated (66.7% male). The most accurate data recording belonged to mechanism of trauma (92.5%) and the least accurate data recording belonged to diagnostic plan (9%). The highest frequency of incomplete data belonged to the site of injuries caused by trauma (71.7%), the number of injuries (34%) and anatomical depth and severity of trauma (34%). Most cases of missing data belonged to diagnostic plan (91%). In 142 (17.8%) profiles only 1, in 241 (30.3%) profiles 2, and in 277 (34.8%) profiles 3 categories were incomplete and data recording in 135 (16.9%) profiles were incomplete in all categories. In total, 82% of the profiles had 1 or more incomplete categories.
Based on the results of this study, the quality of data recordings of trauma patients admitted to the studied emergency department was not satisfying. The highest rate of incomplete data belonged to the site of injury caused by trauma and the highest rate of missing data belonged to diagnostic plan.

Tramadol intoxication is one of the most common intoxications in Iran. In this cross sectional study, we want to evaluate of the clinical findings and complications of Tramadol intoxication in patients referred to Urmia Ayatollah Taleghanihospital at 2012-2013.

After an approval from the ethic committee, total patients with tramadol intoxication if had inclusion criteria, were included in the study and clinical situation, recovery, complications and etc recorded and then analyzed with SPSS 17 Software, p-value<0.05 was significant.

In this study 233 patients were included. No correlation between the sex and complicaltions of tramadol but between marriage and convulsion (p-value= 0.04) and gait impairment (p-value= 0.002) were significant. On the other hand betweenthe time of use of drug and elevation of heart rate (p-value= 0.04) had correlation and elevation of the hear rate in 12-24 hour after the use of drug was seen. Between the history of the use of tramadol and convulsion (p.value = 0.01) also had correlation too.

The most use of tramadol to happened in 20-40 years old and in men compared women. The greater percentage of patients in this study had intermittent use of the drug. Nausea and vomiting were the most common gastrointestinal complications. As most of the patients were admitted. 79.8% weredischarged. The time of referral to hospital could be an influencing factor in outcome. Further studies are recommended.

Anemia is one of the common clinical problems of hospitalized patient in ICU ward that has different etiology. Repeated phlebotomy for laboratory evaluation can be one of the etiologies of anemia in ICU patients that wasn’t known clearly yet. The other causes are inflammation، chronic disorders and gastrointestinal bleeding. In this study we evaluated of the effect of repeated phlebotomy in hemoglobin range in patients admitted to intensive care unit of Urmia Emam Hospital. In this retrospective study we evaluate the clinical records of 841 patients from March 2011 to march 2012 who were admitted to intensive care unit Emam Khomeini and Ayatollah taleghani hospital. 641 hospitalized patients were excluded from study because they had not inclusion criteria’s and only 200 patients were enrolled in the study. The collected clinical date’s from the medical records were included sex، underlying disease، serum hemoglobin level of first and seventh day of admission، mean number and volume of blood sampling during seven days of hospitalization. Anemia was occurred in all of the 200 hospitalized ICU patients. The mean serum hemoglobin level of patients in the first and seventh day of admission was 12. 85 ± 4. 53 gr/dl and 11. 18 ±4. 6 gr/dl respectively. There was no significant relationship between age and sex of patients with serum hemoglobin level. The mean decreased level of hemoglobin in male patient after seven days of admission was 1. 7 gr/dl vs 1. 6 gr/dl in female patients. There was no relationship between underlying disease and degree of decreased hemoglobin. Our study revealed that recurrent blood sampling in ICU patients can causes anemia and it has a negative correlation with mean volume and the number of blood sampling. Repeated phlebotomy can induced Anemia in ICU patients، then it is better to avoid from unnecessary blood sampling as much as possible.

Drug and chemical poisoning is a worldwide problem and mulliple studies have revealed high prevalence of poisoning in Iran. Today, drugs and chemical agents, and poisons are easily available. Drugs are more commonly used for poisoning in Iran and to world. In this study we evaluated epidemiologic status of poisoning with chemical agents and drugs in Taleghani Hospital of Urmia. For this descriptive study, we have studied 2605 patients poisonned with drugs and chemical agents hospitalized in Taleghani Hospital from 2001 to 2004. A questionnaire was completed and then SPSS software was used for data analysis. A majority of patients aged 15–19 years (30.6 %). The study population included 54.9 % female and 45.1 % male. Patients have used the following sustances for poisoning: Drugs (65.9 %), Insecticides (23.3 %), Opioid (5.4 %), Erosive substance (2.8 %), hydrocarbons (1.5 %) and finally Alcohol (1.1 %). Of hospitalized patients, 10.2 % required intensive care. This study shows poisoning in females is more common than in males and most patients aged 15-19 years. Informing general pratitiouners and nursing staff about proper approach and management in poisoning counters will significantly decrease the rate of mortality among them poisoning and true refers to poisons center, decreased of mortality.

Carbon Monoxide is one of the air pollutants which is a by-product of technologic advancement. Carbon monoxide poisoning is one of the most common causes of death due to poisoning in developed countries. This study is a cross sectional evaluation which was performed in Tehran Legal Medicine Organization in 1999. In this year 134 deaths occured due to carbon monoxide poisoning. Male to Female ratio was 2.1/1. The highest rate was seen in young (21-30 yr), workers & house wives. Most cases wereAccidental and individual and occurred in cold months of the year in closed environments with poor ventilation. unintentional. The most common source of carbon monoxide was wall-mounted.