محمد آریایی

Propofol is one of the most commonly used drugs in anesthesia with the pain during an injection is a side effect of this drug. This study was conducted to compare the effect of Lidocaine, Magnesium Sulfate, and Ketamine on reducing pain caused by intravenous injection of Propofol in patients Undergoing surgery.

In this double-blind randomized clinical trial study, 80 patients aged 18 to 65 years were randomly blocked and assigned into four groups including Lidocaine, Ketamine, Magnesium Sulfate and Normal Saline. The pain was measured with the Ambesh Score. Hemodynamic changes of patients were evaluated in 1, 3, and 5 minutes.

The patients in Lidocaine, Ketamine, and Magnesium Sulfate groups with 75%, 70%, and 55%, respectively, did not feel pain after Propofol injection compared to Normal Saline group (25%) (P<0.05). The mean time trend of Systolic and diastolic blood pressure and mean arterial blood pressure between the studied groups were significant (P<0.05).

The use of Lidocaine or Ketamine during Propofol injection can be effective in reducing pain during injection in patients undergo surgery.

Permanent first molars are susceptible to caries due to their particular anatomical form, early development and lack of knowledge of parents about their permanence. This study was conducted to determine the index of first permanent dental careis (DMF6) and some of its related factors in 12 year-old students.
This descriptive-analytical study was carried out on 400 students (200 females and 200 males) using combined method (stratified and cluster sampling) from public and non-governmental schools in Gorgan, northern Iran during 2015-16. First permanent molar examination was carried out. The parent's education level, frequency of toothbrushing and daily consumption of sugar-containing snack foods was recorded in a questionnaire. Each decayed, missing and filled first permanent molar tooth was given number one. These numbers were combined to compute the DMF6 index for each individual.
The DMF6 index was zero in 19.5% and the DMF6 index was determined to be between 1 and 4 in 80.5% of the children. The mean DMF6 index was 2.23±0.07 and significantly higher in girls (2.39±0.10) than in boys (2.07±0.11) (P Dental caries prevalence among 12-years-old students in north of Iran is higher (2.23) than global standard until 2020 (lower than 1). Gender of child, parent’s education, frequency of toothbrushing and consumption of sugar-containing snack foods plays an important role in the rate of dental caries.

Leishmaniasis is a parasitic disease caused by protozoan called Leishmania that is transmitted by sand flies. The aim of this study was to determine the demographic and clinical characteristics of children with cutaneous leishmaniasis in Isfahan province, Iran.
This was a cross-sectional study on all children patients with age of five years and younger in Isfahan province during 2011 to 2015. Demographic and clinical characters of patients were presented as the number and percentage. The mean age of patients according to sex was compared using t test via SPSS software.
Findings: Of 1529 patients, 51.8% were boys, 56.0% were in rural areas, and 92.9% were Iranian. The mean age of patients (± SD) was 2.71 ± 1.5 years. The smallest patient was 2 months old. Most of the patients were in the age group of one year (20.4%) and the lowest were in the age group of less than one year (5.6%). Leishmania major was the most common (91.8%) cause of disease. Wound size at 63.37% of patients was more than 2 cm. In 11.2% of patients the number of wounds was equal or more than 4 wound. In children, face was the most common (33.7%) region of wound.
Leishmaniasis is endemic in Isfahan province, and children are in high risk for incidence of disease. However, the process for combating the animal reservoirs and mosquito vector should be considered as a priority to control the disease. Furthermore, the facilities should be provided for accurate and timely diagnosis and treatment of patients.

Aims: As a growing problem, obesity is one of the most important worldwide health problems. One of the major factors leading to obesity is the sedentary lifestyle. The aim of this study was to investigate the effects of motivational interviewing on the physical activity intention in the obese or overweight women, using the protection motivation theory (PMT).
In the clinical trial study, 60 obese or overweight women referred to the health centers of Gorgan were studied in 2015. The subjects, selected via non-probable and available sampling method, were randomly divided into two groups including control and motivational interviewing groups. Data was collected using a researcher-made questionnaire before the intervention and 2 and 6 months after in both groups. Data was analyzed by SPSS 18 software using independent T, Chi-square, repeated measures ANOVA, LSD, and one-variable and multivariable linear regression tests.
Findings: The scores of all the constructs of PMT in motivational interviewing group significantly increased 2 and 6 months after he intervention (p0.05). The most powerful constructs predicting the intention towards the physical activities 2 months after the intervention were perceived-reply efficiency, self-efficiency, and perceived intensity, successively. In addition, such factors 6 months after the intervention were attitude and perceived intensity, successively.
The motivational interviewing increases the scores of all the constructs of PMT, which leads to an increase in the physical activity intention in the obese or overweight women.

In all educational systems, the academic achievement is the most important indicator of success for the scientific and educational activities; therefore, the present survey was aimed to study the relationship between self-efficacy beliefs and perceived social support with academic achievement in high school students in Ali Abad-e- Katoul city of Golestan province.
This cross-sectional study was conducted on 460 first and second year high-school students (230 male and 230 female) using cluster sampling technique. The data was collected by three standardized questionnaires (support from parents, teachers and friends and self-efficacy) and analyzed using descriptive and inferential statistics including Pearson correlation and Multivariate Regression model. Significant level was considered significant as pFindings:The majority of them 238 (51.7%) were in the second year of high-school with the age of 17. Based on Pearson coefficient, there is a significant relationship between perceived support from family (pAccording to the present results, a family-based intervention appears likely more beneficial to provide more support for students to achieve higher academic.

Because of the nature of their profession, nurses experience high levels of stress, and neglect of understanding and coping with this stress will cause irreparable effects. Accordingly, the present study was performed to investigate the relationship between Job stress and coping strategies among intensive ward nurses in Gorgan.

This was a correlational descriptive study done during year 2014. The instruments used in this study included a demographic questionnaire, Expanded Nursing Stress Scale (ENSS) and the Folkman and Lazarus Coping Style Questionnaire. The research environment included critical care unites of Gorgan university hospitals. Sampling was carried out by the census sampling method. Overall, 74 nurses participated in the study. After data collection, analysis was performed with the SPSS software (version 16). For the analysis of data in terms of variables, descriptive statistic and deductive statistic (Pearson correlation, stepwise regression) were used.

The mean age of the participants was 33.39 ± 6.33 years. The most stressful condition was conflict with the supervisor (2.65 ± 0.59). The most commonly used strategies were self-control (5 ± 14.18). The results of multiple regression analysis showed that the variables gender (21.57 = β, and P = 0.014) and working at the dialysis unit (27.08 = β and P

According to the high level of some stress dimensions such as conflict with supervisor among nurses, and also the relationship between job stress and factors such as working at the dialysis ward and gender, it is necessary for nurse managers to apply some measures to prevent and reduce stress; these measures could include improving the work environment, education on coping methods, training and sufficient support of personnel.

Vitiligo is one of the most frequent skin disorders with a prevalence of 1-2% in different populations. Although many theories have been suggested for its pathogenesis, but the most popular hypotheses is the role of autoimmunity in Vitiligo. This study was done to evaluate the thyroid dysfunction and thyroid autoantibodies in patients with Vitiligo.
This case-control study was carried out on 45 patients with Vitiligo and 45 age- and sex-matched healthy individuals as control group. Age, gender, duration of the disease and type of Vitiligo were collected through a standard questionnaire. Thyroid autoantibodies including thyroglobulin antibody, anti- thyroglobulin and thyroid peroxidase antibody, and anti-TPO thyroid hormones Tetraiodothyronine (T4), Triiodothyronine (T3) and thyroid stimulating hormone (TSH) in Vitiligo patients and healthy volunteers were measeared.
Serum level of T4 was significantly reduced in Vitiligo patient compared to controls (P This study showed that the thyroid dysfunction particularly hypothyroidism and anti-TPO is more common in Vitiligo patients.

The right information on current situation such as physical space, equipment and manpower make it possible to assess emergency activities as well as to manage and provide qualified services to patients. The aim of this study was to determine human and physical resources in health houses and health care centers to provide emergency services in Golestan province.
Materials and The present descriptive cross sectional study was performed in Golestan province in 2012. The study population was health houses and health centers (both rural and urban). A multi-stage sampling method was exploited and required data were collected by check list through interviews and observations. All stages of this research project were conducted ethically. Data were analyzed by descriptive statistics using SPSS 16.
The results of this study show that about 17.9 percent of health houses had no male health workers and a lack of female health workers was noticed in 2.4 percent of them. Similarly, there is not any nurse in 38.9 percent of health care centers. About 94.4 percent of centers suffered from having male nurse’s aid and 97.2 of them had no female nurse’s aid. The results further indicated that most of health houses were in a good level with regard to medical equipments (66.7%) and needed medications (63.6%). The majority of health care centers (63.9%) were indeed at intermediate level considering injection chamber and at very week level 52.4%) from the wound dressing point of view. The studied centers lacked the requisite medications and were at low levels. 74.33 percent of health care centers suffered from an apparent lack of dressing room facilities. About 85.3 percent of health centers showed ambulance deficit.
According to the low levels of personal resources, equipment and physical spaces in studied health care centers, it is necessary to consider appropriate measures in order to improve the situation in these centers

Birth defects are important causes of childhood morbidity and disability. This study was done to determine the incidence and pattern of birth defects in live birth in cities of Golestan province, north of Iran. This descriptive study was carried out on 92420 live births in 13 hospitals in Golestan province, northern Iran from 21 January 2008 to 20 March 2011. The newborns were examined for the presence of birth defects. Gender, type of birth defects and residency of parents according to city in Golestan province was recorded for each newborn. The incidence rate of birth defects, in Gorgan, Kordkoy, Aliabad and Gonbad was 20.46, 12.53, 10.86, and 8.99 per 1,000 live births, respectively. The incidence rate of birth defects western area (including Kordkoy, Bandargaz and Kordkoy), center (Gorgan, Capital city) and eastern area (including Aliabad, Gonbad, Minodasht and Kalaleh) of Golestan province) was 9.3, 20.46 and 8.79 per 1,000 live births, respectively. Cardiovascular anomaly was the most frequent birth defects. The incidence rate of birth defects varies in diferent area of Golestan provine and overally was lower than the other region in Iran.

Musculoskeletal disorders are the most common occupational complaints bringing about increased financial burden and reduced social productivity. This study aimed to determine the prevalence of musculoskeletal disorders and their relationship with psychosocial factors in the staff of organization. In this cross-sectional study, 675 staff of the organizations in Gorgan where selected via cluster & stratified sampling. The instruments Nordic standard questionnaire and job content including areas of job demands, decision latitude, job nature, social interaction with managers and colleagues. We analyzed the data by independent t-test, chi-square test and logistic regression (P≤0.05). Seventy-seven of participants (11.4%) suffer from neck pain, 39 (5.8%) from shoulder pain and 97 (14.4%) from back pain. Multivariate logistic regression showed a significant relationship between neck pain and the support given by supervisor and Colleagues. Respectively, Freedom of decision-making and support are the most common factors associated with shoulder and back pain. Based on the results, the support of supervisor & Colleagues and the freedom of decision are the risk factors associated with musculoskeletal disorders.

Hypertension is one of the most common chronic diseases all around the world and majority of hypertensive patients suffer from hypertension problems due to lack of treatment adherence. The current study aimed to investigate the effect of motivational interviewing on adherence to treatment in patients with hypertension and its comparison with standard cares. This randomized clinical trial was done during February to October 2014. In total, 140 of hypertensive patients were selected using multi-stage cluster sampling method from two urban health centers located in Gorgan City, Iran, with regards to the inclusion criteria and allocated randomly into two groups; motivational interviewing (70 participants) and control (70 participants). Data collecting instruments were demographic questionnaire (personal information, laboratory indices and clinical symptoms), general self-efficacy scale and treatment adherence questionnaire of patients with hypertension. Data were analyzed in SPSS 18 software using paired T and Independent T tests. Motivational interviewing increased total score and the mean score of all dimensions of the adherence questionnaire (except for weight control and stress reduction) (p<0.05). After 6 month, systolic blood pressure and diastolic blood pressure also decreased significantly in the motivational interviewing group (p<0.05). Motivational interviewing is likely beneficial to improve and promote medication adherence and blood pressure control in patients with hypertension.

Today's competitive environment and the development of science and technology has made the use of e-learning inevitable in human society. In the last decade, according to some challenges such as Increased demand for higher education, Inadequacy of funds, Inadequacy of full-time faculty and lack of geographical limitations put e-learning and teaching up in center of full consideration. Currently, the traditional methods of training are not able to respond to the educational needs of lifelong learners. Hence, this study was conducted with the aim of investigating factors affecting the development of e-learning from the perspective of students.. With regard to the number of faculties at Golestan University of Medical Sciences in the year 1392, a total amount of 170 students were selected by stratified random sampling method., Data gathering tool was a questionnaire consisted of two parts. The first part was demographic information and the second part was Standardized questionnaire from Enayati et al. After coding and entering data into Spss16, descriptive and inferential statistics such as the mean and the associated t-test and ANOVA were used. Results obtained from the students’ viewpoints suggested that factors examined in the study influenced the development of e-learning, and based on their order of priority included respectively: infrastructure hardware and software, Social Communications and Collaboration Technologies, content of teaching and provisions of learning, method of assessing learners, Educational fields, and finally the attraction of students. In addition, examining the role of effective factors in the study divided bygender, education, and Faculty had no significant relevance (p value>./05). According to the results of the data analysis, therefore, it may indicate that all the factors examined at the University had an impact on e-learning. Moreover, hardware and software among these factors in frastructure were the most important ones in the field of e-learning.

Neonatal sepsis is a remarkable factor in mortality, morbidity, neonatal and perinatal complications. Group B Streptococcus (GBS) is the primary cause of invasive disease in infants and pregnant women. This study aimed to determine the relationship between antimicrobial resistance of the bacteria colonized in the vagina and rectum of pregnant women and early neonatal infection. In this prospective study conducted on 282 pregnant women, bacterial sensitivity to ampicillin, cefazolin, erythromycin, vancomycin, gentamicin, amikacin was measured. Furthermore, the relationship between rectal and vaginal colonization of mothers and early neonatal sepsis was evaluated. Of 98 positive rectal cultures, 49 (50%) were Gram-positive cocci and 49 (50%) E.coli. of 143 positive vaginal cultures, 136 (95.1%) were Gram-positive cocci, 7 (4.9%) were E.coli and two were positive GBS. We could find definitive neonatal sepsis. Significant correlation was found between a history of urinary tract infection and the mother's positive rectal culture (P =0. 03). Clinical sepsis in neonates is correlated with positive rectal culture (P =0. 001) and the positive E.coli vaginal cultures is associated with suspected neonatal sepsis (P =0.007). Gram-positive cocci were resistance to ampicillin and gentamicin, and E.coli was resistant to ampicillin, erythromycin and vancomycin. Because of resistance to ampicillin, we recommend cefazolin due to its sensitivity to organisms and safety in pregnancy.

Subjective well-being, a field of positive psychology, attempts to assess the cognitive and emotional lives. Given the fact that nursing and midwifery students are exposed to stress in clinical settings, we aimed to assess subjective well-being to promote educational programs. This across-sectional study was conducted on 104 nursing and Midwifery students selected via simple random sampling, 2013. The instruments, filled out by students, were a demographic checklist and Kyeez subjective well-being questionnaire consisting of three domains of emotional, social and psychological. We used mean and standard deviation for data description and T-test and ANOVA for analysis. The mean score of subjective well-being was 203.20 in nursing and 210.21 in midwifery students. In nursing students, the Mean score in emotional, psychological and social domain was 44.05, 93.40 and 65.74, respectively, and it was 45.72, 94.78 and 69.55, respectively in midwifery students. Gender was the only variable associated significantly with subjective well-being of nursing students (P>0.05). Given the high score of subjective well-being and that of its domains, we recommend applying some educational programs with the consideration of emotional, psychological and social aspect of students

Ever decreasing rate of birth and death accompanied with the increasing rate of life expectancy has led to the increase of old population, especially in the developing countries. This study aimed to estimate the association of demographic, socio-economic features and some health problems with the nutritional status in older people. A cross-sectional study was designed and conducted by utilizing two-stage cluster sampling. The total of 541 subjects were included. MNA questionnaire was used to evaluate the nutrition status of the elderly. Data were analyzed using one way ANOVA and hierarchical linear regression. The relationship between qualitative variables was also evaluated by Chi-square test. The prevalence of malnutrition and the risk of getting malnutrition was 4.8% and 44.7 %, respectively. The women participants got lower score in nutritional status. The old people taking more than three drugs were were suffering from malnutrition by 58/8 %. About 22/4 % of the subjects lived alone, and there was a statistically significant relation between living alone and malnutrition. Daily consumption of 3 main meals, fruits and vegetables, and good sources of protein was higher in the elderly with well nutritional status than in at-risk and malnurished eldely. There was a significant relationship between dental and mental conditions and malnutrition, and also age and socio-economic features were negatively related with the nutritional status. Considering the relationship between malnutrition and such factors as socio-economic status, depression, dietary patterns and oral health, it seems that besides nutritional intervention, socio-economic support has noticeable importance, especially for women.

Self-care means enabling individuals to manage special circumstances، such as illness، chronic diseases and having more control over life. Women are more susceptible to serious health risks such as obesity and overweight compared to men، therefore this study was conducted in the city of Gorgan to determine the knowledge، attitude and behavior of women regarding the self-care behavior. In this descriptive- analytical study، 420 women referred to health centers of Gorgan were recruited through cluster random sampling. Data were collected using the standard general self-care questionnaire. Information such as barriers and facilitators of self-care behavior، knowledge، desire and performing self-care behaviors of individuals were evaluated. Data were then analyzed using descriptive statistics and analytical tests in SPSS software (version16). The mean age of samples was 33. 07 ± 12. 2 years. Among all the tested individuals، 49% (n=206) had a satisfactory knowledge about Self-care، 36. 4% (n=152) had a tendency to perform self-care and 21. 8 percent (n=92) were performing self-care related activities. There was a significant relationship between knowledge and performing self-care (P= 0. 0001)، attitudes and performing self-care (P=0. 0001) and between knowledge and behavior (P=0. 0001). Due to the relative knowledge، attitude and unfavorable performance of individuals، appropriate educational interventions are recommended to increase knowledge. Moreover the awareness and attitude of the participants should also be changed using attitude change techniques such as in-depth interviews and subsequently its improvements will occur.

Job satisfaction Increases individual efficiency and commitment to the organization، ensuring the physical and mental health، life satisfaction and accelerate the learning of new skills on the job. The aim of this study was to determine the status of health professionals› satisfaction in the Golestan province. In this cross- sectional study، 1،275 health workers of Health centers in the Golestan province in the year 1391 were participated using the census method. Data was collected using Herzberg job satisfaction questionnaire. The data were analyzed using SPSS software، ANOVA and t-Test at the significant level of 0. 05. Job satisfaction in terms of staff maintenance and support and given the potential and experience of individuals in granting liability were at dissatisfied level، In terms of corporate communications، career development، salary and benefits، challenges and job management، at relatively dissatisfied and from the aspect of social acceptance level was at relatively satisfied. Job satisfaction was significantly associated with work experience (P=0. 049)، ethnicity (P=0. 009) and city of service location (P=0. 001). Due to poor job satisfaction levels، effective actions should be taken to improve organizational communication، career development، salary and benefits، social acceptance، staff maintenance and support، management، Job challenges، and granting responsibilities based on the ability and experience of the individuals.

Background an Aging trend especially in developing country is increasing. This study aimed to assess the nutritional status of the elderly and its associated factors in Gorgan. This is a cross sectional study that two-stage cluster sampling method was used for considering participant. The data were collected using Mini Nutritional Assessment and anthropometric questionnaire which was referred to the elderly inhabitant in urban area. 541 elder were interviewed and data were analyzed by chi square, independent T test and one way ANOVA tests. The prevalence of malnutrition was %4/8 and nearly %44/7 of the elderly were at the risk of malnutrition. %51/9 of the elderly were on a special diet due to a disease or specific condition. Malnutrition frequency and the risk of it were higher in woman than men and the difference between sexes was statistically significant. BMI, mid arm circumference and calf circumference measures in elderly with malnutrition were less than elderly with good nutrition, and the difference was statistically significant The risk of malnutrition in elderly who exposed to socio-economic, mental and also dental difficulties, living alone and female old age was higher than others groups. The implementation of supportive and nutritional programs is more important in this group.

Students are under pressure and stress because of their status in the society. So the university’s student counseling agent is offering consultative services in order to help and guide the students in solving problems and improve their compatibility. The objective of the current study was to investigate the student’s referral proof to the Golestan university of medical sciences’counseling agent. In this cross- sectional study conducted in 2008-2009,On, via census sampling, 345 students of various fields, who referred to the counseling agent.Gathering data’s methods were based on questionnaire that is designed based on Health Ministry’s counseling agent’s goals. Data were analyzed by SPSS statistical software and descriptive statistics and chi square test and ANOVA with significance level of 0.05. Referred student’s reference’s abundance to the counseling agent in the years 2008-2009 showed that from the whole 345 referred people the highest number of referrals by order were: 154 people (44.6%) because of mental problems, 66 people (19.1%) because of marriage problems, 45 people (13%) because of educating problems, 39 people (11.3%) because of communicating problems, 29 people(8.4%) because of suicide problems and 12 people (3.5%) were because of other factors. This article’s results are showing mental, emotional, educating, behaving, cognitive and family problems and also the student’s marriage’s problems. Cognition, diagnosis, adjustment and early removal of failures, abnormalities and possible disorders confirm mental caring systems expanding importance and supportive cures.

Background and Lack of awareness of people about the future environmental risks posed by wastes is the most important problem of this sector. Awareness, and then cultural education in this area, can be a breakthrough to this significant environmental problem. This study aimed to assess the degree of awareness of the people of the cities of Gorgan, Gonbad, and Aliabad Katool (Iran) in relation to municipal solid waste management. In this descriptive-periodic study in 2012, a questionnaire with a Cronbach's alpha of 0.78 was used. 550 questionnaires were completed: 200 in different areas of the city of Gorgan, 240 in different areas of the city of Gonbad, and 110 in different areas of the city of Aliabad Katool. Data were analyzed by SPSS software. The awareness of the citizens in the studied cities in the area of waste-related diseases and the waste effect on the environment was satisfactory. The rate of citizen's awareness in the field of recycling and ways of reduction of household waste and the methods of waste disposal was above the average. The awareness in the area of existence of urban recycling organization and its duties was rated weak to average and in the area of compost, it was weak. The performance of citizens in the area of relation of people with urban materials recycling organization and regional municipality regarding solid waste materials was rated very weak to weak and in the area of source waste separation, the performance was rated average. Considering the results obtained, the information of people regarding compost production and existence of urban recycling organization and its duties was low and, it is necessary to provide certain educational programs for increasing public awareness.

Background/ Poisoning is One common cause of referred cases, especially in the adolescent and young group to hospital emergency department. This study was designed to determine Epidemiologic of poisoning in teaching hospitals, shiraz in 1387 This is a cross-sectional study that 266 sample via random sampling with 95% confidence interval and α 0.05 were considered. There were 47% female and 53% male. 67.2 percent of poisoned patient were single and 32.8% were married. This study showed, highest rate of poisoning was between the age of 20-35 years. Most common season of poisoning was in spring. Overall mortality of our study was 1.6 percent. Regional epidemiological information, make rational use of resources in order to prevention and control of poisoning and with using analysis of effective factors will be reduced poisoning by policymakers and planners.