جلال الدین امیری

Marriage at a young age, especially when a person has not yet reached the necessary psychological and social maturity, can cause serious harm to the individual, family, and even society.

The aim of determining the factors affecting early marriage and its health consequences in women under 18 in Migrant City.

The research design was mixed method, including a descriptive-analytical cross-sectional study and then a qualitative study that was conducted on migrant women under 18. The sampling method was a census. In the cross-sectional study, 133 women and in the qualitative study, 36 women were studied. The data collection tool in the cross-sectional study was a researcher-made questionnaire and in the qualitative study was interview. In the cross-sectional study, the Chi-square test and in the qualitative study, content analysis was used.

The results showed that the marriage age of most women was 13 to 14 years old. It has been reported that the age of women's first menstruation was 12 years old (28.6%). There was a statistically significant relationship between mother's occupation, father's occupation, parents' monthly income and the age of first menstruation with the age of marriage. A qualitative study about the problems of early marriage included four main themes: physical problems, mental-psychological problems, developmental and developmental problems, and social problems following early marriage.

The results of this research provide a more detailed insight into the phenomenon of child marriage and can be used for interventions related to early marriage, especially in the growing immigrant population.

Epidemics and deaths caused by influenza viruses are an important concern worldwide. The use of neuraminidase inhibitors such as oseltamivir is an effective and valuable way to treat the diseases caused by these viruses. However, the mutation in several parts of the gene leads to the emergence of drug-resistant strains, and an ever-increasing rise in drug-resistant strains is a global problem. Histidine-to-tyrosine mutation at position 275 (H275Y) of neuraminidase protein is one of the most common oseltamivir resistance mutations. This study aimed to detect H275Y mutation in influenza A (H1N1) virus circulating in the Hamadan province of Iran using real-time polymerase chain reaction  (RT-PCR).

This cross-sectional study was conducted on 110 swab samples isolated from patients with suspected influenza virus infection between 2015 and 2016. Ribonucleic acid (RNA) was extracted from samples and the RT-PCR method was used to determine virus types and subtypes. The positive samples were evaluated for detection of H275Y mutation using RT-PCR.

Out of 110 patients in this study, 50 (45%) were females and 60 (55%) were males. The mean±SD age of participants was 40.74±2.42 years. Influenza A (H1N1) virus was found in 22 (20%) out of 110 patients, including 9/50 (18%) females and 13/60 (21.7%) males. There was no significant relationship between the virus and gender (P=0.81). No drug resistance related to H275Y mutation was observed in 22 positive cases.

The findings indicated that no drug resistance mutations have occurred, and oseltamivir is still an appropriate option to treat infections caused by the influenza virus in Hamadan province, Iran. However, due to the increasing number of resistant strains, an annual review of oseltamivir resistance is recommended and further studies are needed in this regard.

Urban health centers are one of the most important centers for providing primary health services. According to the wide range of health centers and the number of services provided by these centers, a significant portion of the community health system resources are allocated to these centers; therefore, the determination and continuous monitoring of the effectiveness of these centers can play a significant role in improving the efficiency of health resources and preventing waste of resources. The purpose of this study Assessment of Technical Efficiency of Comprehensive Health Services Centers of Hamadan by Data Envelopment Analysis (DEA) in 2019.

This descriptive-analytic study evaluates the effectiveness of Hamedan comprehensive health centers services using the data envelopment analysis method. Inputs include: number of physicians and number of employees (midwife, specialist in the fight against diseases.). Outputs include: number of examinations by physician, midwifery services, vaccinations, injections and dressings.

In 2018 the average technical efficiency of the comprehensive health services centers was 0.751, the mean management efficiency was 0.85 and the mean efficiency of the scale was 0.88. Of the total centers of comprehensive health services surveyed, 6 centers have technical capacity of 1 and 13 centers with a technical efficiency of less than 1.

In centers with efficiency less than 1, there were initial and optimal values of the same and different inputs. Therefore, it is suggested that these centers reduce their inputs as much as possible so that they can achieve maximum efficiency.

Reform program in Medical education including integration of basic and clinical sciences without attention to professors and students’ views has been done in Hamadan university of medical sciences from 2011, so this study was conducted to examine the viewpoints of the professors and students toward this program.
This cross-sectional study has been done on students and professors involve in reform program through census method. For collecting data a researcher- made questionnaire that its’ validity and reliability confirmed was used and included questions regarding the objectives, horizontal and vertical integration and quality of education centers. Data were analyzed using Descriptive Statistics, Chi-square, Kruskal Wallis tests and One-Way ANOVA through SPSS software.
Totally 118 students and 12 professors participated in the study. 47.05% of the students reported that the program's goals were not initially elaborated. Effective factors in Students’ satisfaction were respectively the quality of education centers and functioning of the departments including surgery, pediatrician and internal (P based on results, more than half of the students and professors who participated in this study were satisfied with the reform plan.

Introduction & Ileus is one of the common complications in hospitalized patients as well as it is the most common reason of delay in discharge from the hospital due to abdominal surgeries. Present study with aim of investigating the results of chewing gum on bowel movements of digestive system after appendectomy was designed.
In this clinical trial using the related sample size formula 40 patients’ means that underwent appendectomy surgery in Besat- Hamedan Medical Center were randomly classified into the intervention and control groups (20 people per group). Inclusion criteria for the study included the age of over 15 and having appendectomy surgery and the exclusion criteria included hypothyroidism, hypo-parathyroid glands, electrolyte disorders, neuro muscular diseases and drug addiction. Method of anesthesia was similar in both groups. For the case group the chewing gum manufactured by the same factory and in the same flavor was prescribed within the four, ten and eighteen hours after the patient's recovery. No treatment was applied to the control group. One hour after the patient’s recovery and stabilization of the vital signs, the bowel sounds were examined by stethoscope by researcher in the case and control groups every two hours. The researcher evaluated flatulence and defecation by asking the patients. The collected data were analyzed by SPSS version 17 and the descriptive statistics were used in the required cases and the t-test was used for the evaluation of significance of the data. The significance level of data is considered lower than 0.05.
The average time to hear the first bowel sound in experimental group was 3.30 ± 1.17 hours and in control group it was 2.60 ± 1.23 hours. Therefore there was no significant difference (P = 0.073) between the experimental and control groups. The average time to gas-passing in experimental group was10.90 ± 3.52 hours and in control group it was 17.50 ± 9.90 hours that showed a significant difference (P = 0.008) between the experimental and control groups. Average time to defecation in the experimental group was 25.40 ± 5.03 hours and in control group it was 37.70 ± 13.98 hours. Therefore there was a significant difference (P = 0.001) between the experimental and control groups. The average time to receive oral feeding in the experimental group was 17.75 ± 4.88 hours and in control group it was 18.50 ± 5.18 hours (P = 0.641). The average time to leaving the sickbed in the experimental group was 8.85 ± 5.60 hours and in control group it was 10.55 ± 4.29 hours (P = 0.28).
According to the results of this study, the average time to gas-passing and defecation in gum recipients group was significantly less than the control group. Complementary studies and finding ways to find out the chewing gum effects on reduction of Ileus time without questioning the patient about the first gas-passing and defecation after surgery was recommended.

Introduction & Hypernatremia is associated with serious complications in infants. Given the high morbidity and mortality of neonatal hypernatremia، and since some complica-tions can be prevented، this study was aimed to examine the prevalence of hypernatremia in hospitalized infants and related risk factors. This cross-sectional study was performed on 1923 neonates hospitalized in Bahrami Hospital affiliated to Tehran University from October 2011 to October 2012. Demographic data، ward، gender، mode of feeding، gravidity، admission season and method of delivery related to the infants were recorded. For infants with a serum sodium above 150 meq/lit، additional information were collected، including serum urea level، gestational age، date of birth، birth weight، admission weight، head circumference and clinical symptoms. Fi-nally، the data were analyzed using the SPSS software. 74 out of 1923 neonates had serum sodium above 150 meq per liter، which their mean Na was significantly associated with their age groups (P=0. 04) and weight loss (P=0. 008). Furthermore، the mean of urea in these neonates was significantly related to weight loss (P<0. 001). The prevalence of hypenatremia in the hospitalized neonates was 5. 2% in autumn، 4. 9% in winter، 1. 8% in spring and 3. 4% in summer. The common symptoms of hypernatremia، icterus and weight loss often cannot be evaluated due to late referral (> a few days after birth) or to the non-exact weight at the birth time (risk factors). The study results confirmed that weighing the neonates at 72 to 96 hours after birth can prevent hypernatremia in infants.