فهرست مطالب نسرین فولادی

 

To deal with the more and sudden prevalence of covid-19, dentists should be aware of recent developments, especially the guidelines for the prevention of covid-19. This study aimed to assess of compliance with guidelines about the prevention of covid-19 in the dental setting in Ardabil city in 2022.

This cross-sectional (descriptive-analytical) study was conducted in the period from May to August 2022. In this study, 254 general and specialist dentists were examined using full-census sampling. The tool for collecting information was a researcher-made questionnaire that was valid and reliable based on the country's guidelines, which included 6 demographic and 41 questions related to compliance with the instructions related to the prevention of covid-19. After collecting the data, they were classified and analyzed using the chi-square and Fisher's exact test. SPSS software version 26 was used for data analysis. The acceptable error level was considered 0.05.

The survey results showed that the rate of compliance with guidelines about the prevention of covid-19 in the index of patient management before treatment was estimated at 45%, in the index of required equipment and personal protection requirements were 72.42%, and in the index of required therapeutic action during the pandemic was 42.81%. There was a significant difference in compliance with the guidelines related to the prevention of covid-19 based on education and work history (p<0.05). However, there was no significant difference in compliance with the guidelines related to the prevention of covid-19 based on gender, age, marital status, and history of corona infection.

The level of compliance with the guidelines related to the prevention of covid-19 in the dental centers of Ardabil city was at an average level and was influenced by factors such as the dentist's education and work history.

Cervical ripening usually starts before the onset of labor contractions and is necessary for dilatation and embryo passage. Considering the importance of vaginal delivery and reduction of cesarean risk, cervical ripening in pregnant women is a priority for Gynecology. Therefore, this study was performed with aim to compare the effects of isosorbide mononitrate and estradiol on cervical ripening and labor induction and the complications of these two drugs. This double-blind randomized clinical trial was performed in 2016 on 99 pregnant women over 40 weeks of gestation who referred to Alavi hospital in Ardabil. Participants were randomly allocated in to three groups of isosorbide mononitrate, estradiol and placebo. The tablet were placed in the posterior fornix, out-patiently. All three groups were hospitalized after 12 hours. Because of Bishop scores (BS) less than 6, the previous doses were repeated in all groups. Examination of the cervix was performed every 2 hours and blood pressure and heart rate of the mother were checked every 4 hours. Data were analyzed by SPSS software (version 16), one way ANOVA, Chi-square and Kruskal-Wallis tests. P <0.05 was considered significant. The time of cervical ripening up to delivery was similar in Isosorbide and Estradiol groups (p=0.381), but it was significantly shorter in both groups than placebo group (p=0.016). Isosorbide and Estradiol also increased cervical Bishop Score. No significant difference was found between the groups in terms of duration of active phase of delivery (p=0.860). Despite of higher cesarean frequency in placebo group, no significant difference was observed between three study groups in terms of mode of delivery (p=0.484). The drug side effects were higher in Isosorbide and Estradiol groups compared to placebo. Isosorbide mononitrate and Estradiol changed Bishop Score as similar, and reduced the duration of ripening to delivery. Both drugs reduced the hospitalization time to delivery, cost of delivery induction, and improved delivery experience, without need to any aid instruments or surgery

The measurement of the lower uterine segment (LUS) thickness before labor predicts hazardous complications of vaginal birth after cesarean section (VBAC). Vaginal birth after cesarean is one of the most effective methods used to reduce the incidence of cesarean section. Therefore, this study was carried out to evaluate the diagnostic value of sonographic measurement of lower uterine segment (LUS) thickness in uterine rupture during cesarean section and its associated factors in women with and without previous cesarean section.
This prospective cohort study was conducted among 168 pregnant women in two groups of with and without the history of cesarean section (84 individuals per group) referred to Ardabil Alavi Hospital, Ardabil, Iran, in 2016. The thickness of the LUS was determined through transabdominal ultrasonography between the gestational ages of 36 to 40 weeks. At the time of cesarean section, the thickness of the women’s LUS and newborns’ weight and Apgar score were measured and recorded. Additionally, uterine rupture was recorded in patients with the past history of cesarean section. Moreover, the relationship between the LUS thickness and maternal age, gestational age, the indication for previous cesarean section, interdelivery interval, embryo weight, and abnormalities of erythrocyte were determined. Data analysis was performed using descriptive statistics and t-test in SPSS software, version 16.
According to the pre-operative assessments, the LUS thickness in the women with and without the history of cesarean section were 4.26±1.99 mm and 6.11±1.6 mm, respectively (P˂0.001). According to the findings obtained from sonography before and during the operation, there was a significant difference between the groups in terms of LUS thickness (P0.05). Based on the results, the LUS thickness of 1.8 mm was considered as the critical cutoff value for predicting uterine rupture.
The measurement ofLUS thickness is a non-invasive technique to predict the uterine rupture, which leads to increased rate of VBAC.

Health Literacy is the capacity of individuals to obtain process and understand basic health information and services needed to make healthy decisions .Therefore, this study was designed to determine health literacy of Middle-aged in Ardabil.
This Cross-Sectional study was conducted on 1049 adults aged 20-60 years attending referred Ardabil health centers in 2015. Data collecting tool was Iranian health literacy questionnaire. Data was analyzed by correlation tests, Chi-square, T-test and linear regression using SPSS (16).
Mean age participants were 39.59±14.1 years. 56.4 percent (n=65) were females. Most participants had Diploma and postgraduate Diploma. Participants had a weak level to access information (76.3%), moderate level in perceive data (59.9%), moderate level in judgment (57.8) and level moderate in use of information (75.1%).
Overall, there was moderate health literacy in Middle-aged. It seems necessary training programs be designed according to the needs of Middle-aged with low health literacy.

Celiac disease is a gastrointestinal disorder that genetic factors have a role on its pathogenesis. The aim of the present study was to determine HLA alleles encoding HLA DQ2 and HLA DQ8 in patients with celiac disease. This descriptive analytical study was conducted on 105 patients with IBS whom referred to the gastroenterology unit in Ardabil، Iran. The patients with positive celiac serology of IgA anti-tTG test were done an endoscopic duodenal biopsy. HLA DQ2 and DQ8 testings were performed on patients. Data were analyzed using descriptive statistics together with Mann-Whitney U and Fisher’s exact tests by SPSS-16. 14 patients were found positive for IgA antibodies against tTG. From these 14 patients 2 (14. 3%) were male and 12 (85. 71%) female. All of 14 patients (100% of case) had also abnormal intestinal pathology according to the modified Marsh classification and 10 patients had type IIIC. 11 patients had only HLA DQ2، 2 patients had only HLADQ8، and one patient had both HLADQ2 andDQ8. Most of patients had positive HLA D Q2. The present study emphasizes that HLA genotypes are an important background to CD development.

Addiction is one of the problems in world threating the social, economic and culture factors. It is essential to have an accurate knowledge about the characteristics of drug users in order to diminish the high-risk behaviors of intravenous drug addicts. This research has been done to assess relationship between individual characteristics and high risk behavior in intravenous drug addicts. In this descriptive-analytic research, 360 drug users were selected from different places in Ardabil city and interviewed by a prepared questionnaire. The data were analyzed using descriptive and analytical tests including t-test, Pearson correlation and ANOVA with SPSS statistical software. The results showed that the age, gender, material status, job position, age of addiction start, age of injection start, injection frequency, injection frequency per day, syringe supply place and the partner’s gender during recent few months had no significant difference compared to drug users with needle sharing and without needle sharing. The educational level of drug users with needle sharing was lower (P=0.037) and the number of new syringe usage per month was also lesser (P=0.001). They predicted to be more likely infected with AIDS (P=0.001) and had a less argument with their partner about using condom, also mostly have not used condom at their last sexual relationship (P=0.001). The average number of their partners during last three months was high (P=0.003) and there was a meaningful relationship between true sense of peril and using condom in drug users with needle sharing group (p=0.001). There is a significant relationship between the true sense of danger and the using condom. It is necessary to have an appropriate advertising to increase using condoms among injecting drug users.

Heart failure is a major cause of hospitalization. Many of the studies shown association between sleep-related breathing disorders and heart failure. Studies have shown that the relationship between nocturnal hypoxia and left ventricular dysfunction can cause significant morbidity and mortality in patients with Congestive Heart Failure (CHF). Sleep related breathing disorders (SRBD) treatment will improve of CHF treatment. This study examines the prevalence of sleep disorder in stable heart failure patients regardless of ejection fraction. This study was a descriptive-analytical study. 108 patients with heart failure were studied. This study was conducted on 108 patients with heart failure. A questionnaire consisting of two parts (part I consistent of demographic information and part II consistent of sleep disorders) and clinical examination (pulse oximetery and echocardiography) were used to collection of data. The data were analyzed with SPSS statistical software and were used descriptive and analytical tests included q square, Pearson correlation and ANOVA. 56 persons (51.9%) of patients were female and 52 persons (48.1%) were male, mean age 65.42 ± 11 years. In total sleep duration, 95 patients (88%) had nocturnal hypoxemia. There was correlation between arterial oxygen desaturation at night with Ejection fraction. This study confirm strong associations between nocturnal hypoxia and left ventricular dysfunction. In clinical treatment of systolic heart failure, SRBD should be consider.

Irritable bowel syndrome (IBS) is the most prevalent gastrointestinal disorder and is one the common conditions seen by gastroenterologists in their daily practice. This study was done to determine the prevalence of celiac disease in patients with irritable bowel syndrome in Ardabil-Iran. This descriptive study was conducted on 105 patients with IBS whome referred to the gastroenterology unit in Ardabil-Iran during 2009-10. Serum IgA anti tTG were measured all patients with positive for antibodies against tTG were candidated for upper endoscopy and biopsy. Data were analyzed using SPSS-16، t-test، Chi-Square and Fisher’s exact tests. The average age of IBS subjects were 31. 4±10. 14 years (range 16-63 years). Celiac disease was diagnosed in 14 subjects (13. 5%). The celiac patient age were 22-55 years with mean of 34. 93±9. 47. Among celiac afflicted patients IBS type D and M observed among 10 and 4 patients، respectivley. Celiac affected female constituted 12 (85. 7%) of all patients (P<0. 05). 10 of these patients were IBS-D and 4 with IBS-M. From 14 celiac patient 4 (28. 57%) were family related، but this rate among IBS patient was 3. 3%، this difference was significant (P<0. 05). This study showed that the prevalence of celiac in patients with IBS is found to be 13. 5% which seem is more than ther studies in other parts of Iran.

Myocardial infarction is one of the most common causes of mortality throughout the world. Utilization of thrombolytic drugs at the first hours upon MI leads to decrease in the rate of mortality. Streptokinase (SK) is commonly used because of its cost and availability. The golden time for maximum effect of SK appeared to be first hours after MI. The drug efficiency diminishes after 3 hours and it will be ineffective after 12 hours. This study was aimed to investigate interval between onset of the clinical symptoms and streptokinase receiving in patients with acute myocardial infarction admitted for drug reception. This cross-sectional study was conducted in 150 patients with STEMI (ST elevation Myocardial Infarction) who were attended to emergency room of Imam Khomeini hospital and fulfilled a questionnaire containing the data about age, sex, educational level, onset of symptoms, referring time to emergency room, SK utilization, past medical history of cardiac diseases, type and location of AMI, contraindications and side effects of SK. In 111 men (74%) and 39 women (26%), the mean for interval between onset of symptoms and drug injection was 8 hour and 27 minutes ± 8 hour and 18 minutes. Only 41% of patients received streptokinase in less than 3 hours after chest pain. The main reasons for delaying in drug consumption were delayed decision to come to hospital in 61% of persons, long distance to hospital for 22% of individuals, delayed admission tor CCU for 13% of cases and delay in physician diagnosis for 0.043% of patients. To have a male sex and residency in city where the hospital was establilished were associated with less-delayed treatment start. However, the educational level, age and history of MI were not correlated with onset of treatment. Our results clearly show that the majority of patients receipt streptokinase more than 3 hours after chest pain. With considering the factors associated with delay to receive SK, teaching the patients with ischemic heart disease and giving information about golden time for thrombolytic therapy and its effect in prognosis as well as extending cardiac disease treatment centers in suburbs are recommended.

Urinary stone disease is one of the common urinary tract complications that can lead to renal failure. It occurs usually in middle-aged and older men The aim of this study was to determine the association between types of urinary stones and risk factors for urinary stone formation in patients referred to Ardabil therapeutic centers. In this descriptive cross-sectional study, 150 patients with urinary stone were followed from March 2008 to July 2009 in therapeutic centers of Ardabil. Data were collected by a questionnaire include demographic factors such as age, gender, body mass index (BMI), Job and Habitation place. Data were analyzed by chi-square test and ANOVA in SPSS 16 software. The level of significance was p < 0.05. 116 of patients (77.3%) had calcium oxalate stone, 15 of patients (10%) had phosphate calcium stone, 10 of patients (6.7%) had acid uric and 9 of patients (6%) had phosphate ammonium stone. The mean age of patients was 41.90 + 14.41 years (48% of patients were 30-50 years old) and the mean body mass index (BMI) was 25.81+3.66. 91 of patients (60.66%) were male and 59 (39.4%) of them were female. There was no significant difference between types of urinary stones and factors including BMI the job of patient, (p = 0.252), habitation place (p = 0.173), history of previous illness (p = 0.207) and history of drug use (p = 0.247). The most common type of urinary stones was calcium oxalate (77.3%) in both men and women however ammonium phosphate (6%) is much less common.

Coronary artery disease is the main cause of mortality in developing and industrial countries. Recently the involvement of infectious agents as a risk factor for Acute Coronary syndrome is drafted. So this study was designed to investigate the probable association between Acute Coronary syndrome and Helicobacter pylori infection. This case-control study was carried out on 300 hospitalized patients with the diagnosis of Acute Coronary syndrome (UA and MI) and 300 hospitalized patients without the history of coronary heart disease. Anti Helicobacter pylori Antibody level was determined by as an indicator of infection history. Using chi-square and t- test the results were analyzed in SPSS software. Results showed that 79 patients (26.3%) in control group and 122 patients (40.6%) in case group were seropositive and the difference was significant. Relationship between cronory diseases risk factors and levels of IgG was not significant. Also the results showed that the rate of hypertension in seropositive patients in case group was significantly upper than control group. Regarding the findings of this study we can conclude that Helicobacter pylori infection probably is a risk factor for Acute Coronary Syndrome. Thus, further studies are needed to elucidate the association between Helicobacter pylori infection and Acute Coronary Syndrome.

Diarrhea is one the important causes of mortality among children in developing countries. The effect of zinc supplementation in reduction the rate of diarrhea is controversial. The aim of this study was to evaluate the effect of zinc supplementation on the severity and duration of diarrhea in children less than 5 years old hospitalized in Ali-Asghar hospital in Ardabil, 2005. This study was a double-blind, randomized, placebo-controlled trial including 228 children with acute diarrhea. The subjects randomly assigned into two placebo and experimental groups (114 patients in each group). The placebo group received glucose (5%), while the experimental group received 20 mg/day Zn sulfate. The severity and duration of diarrhea were assessed during the study. Data were analyzed using Chi-square, Pearson correlation coefficient tests and Students t-test by SPSS software. Our findings showed that most of the patients in both groups were male (age range; 1-12 months, weight range; 3-11 kg, weight percentile; 3-50). These children had breast feeding and complete vaccination. They were the first baby in their family and the majority of them were from urban area (Ardabil city). The severity of diarrhea in zinc supplemented children (74.6%) was less than placebo group (89.5%) (p =0.037). There was no significant difference between two groups in the duration of diarrhea (p =0.737). There also was no relationship between the severity of diarrhea and weight percentile (p = 0.085). Our data indicate that zinc supplementation reduces the severity of acute diarrhea and could be advised in children with acute diarrhea.

Stem cells are a class of undifferentiated cells that are able to differentiate into specialized cell types. The discovery of such cells in the adult mammalian central nervous system (CNS), an organ traditionally thought to have little or no regenerative capacity, opened the door to treatment of degenerative diseases of CNS like Stroke, Parkinson, Alzheimer and Spinal Cord Injury. Thus, here we described the isolation of neural stem cells from the adult mouse brain using the neurosphere assay (NSA) and differentiation of these cells to neural adult cells in details. The rostral part of the subventricular zone (SVZ) of the lateral ventricles in the adult mice was dissociated into single cell suspension and cultured using NSA. Primary neurospheres were counted seven days after plating and then the mean number of neurospheres was recorded. The differentiation of neural stem cells into adult neural cells was accomplished by plating the neurosphere-derived cells in differentiating media. Immunocytochemistry and specific markers were used for the identification of the adult neural stem cells. The cell suspension obtained from the rostral part of the SVZ of the lateral ventricles generated multipotential colonies, called neurospheres, 7 to 10 days post- incubation. The mean number of neurospheres generated from SVZ was 505±62. The multipotentiality of the neurospheres was shown by palting them in differentiating media and generating adult neural cells including neuron, astrocyte and oligodendrocyte. Owing to their rarity and paucity of neural stem cell specific markers, the NSA is a common and selective method for isolating and understanding the biology of embryonic and adult neural stem cells.

Due to rapid population growth, many activities performed to find ways to prevent pregnancy around the world. Vasectomy is one of the most effective contraceptive methods but despite the benefits, it's using incidence is very low. It is important to involve men in order to population control. This study was aimed to describe the experiences of a group of men who had vasectomy and their sexual satisfaction after Vasectomy. A combination of qualitative and quantitative study (Triangulation method) was used on forty men who had been vasectomized in the city of Ardabil before 2006. The method the thematic oral history was used. Questionnaire about sexual satisfaction after vasectomy was prepared and completed by sample subjects (101 people). The results were analyzed by SPSS software. The following three descriptive categories were developed from the men's experiences: influencing factors for doing vasectomy; outcomes of vasectomy; vasectomized men as advisers of the procedure for other men.Frequency of intercourses in 65.4%, sexual desire in 64.4%, sexual pleasure in 59.4%, duration of sexual intercourse in 66.3% and sexual ability in 68.3% of subjects did not change after sterilization. Family planning programmes must consider the clients sociocultural background. During explanations about vasectomy, the dissemination of the experiences of vasectomised men could improve the confidence and interest of the men to the method and may promote men's involvement in reproductive health.

Toxoplasmosis is an important zoonosis parasitical disease. Infection with Toxoplasma gondii in transmission of parasite to fetus or its reactivation among immune-compromised persons can lead to server clinical symptoms. The aim of study was to determine immune level of Toxoplasmosis among women who were to get married and have referred to Health Center of Ardabil. In this study 272 blood samples of women who had referred to health center of Ardabil in 2007 were collected. Samples were tested with ELISA method to detect Anti-Toxoplasma IgM and IgG Antibodies. The tests showed that 42.3% of women were IgG Positive, 57.2% were IgG negative and 2.6% women were IgM positive and also IgG positive. They have (IgG positive women) 11.3% family history of abortion, 96.5% eating raw vegetables, 92.2% eating half cooked meat, 89.6% not washing the vegetables with disinfectants, 29.6% animal contact, 57.4% contact with raw meat and 94.8% used piped water. Since 57.7% of women who were to marry in Ardabil city were negative from the view point of Toxoplasmosis, health education for elimination of risk factors especially within pregnancy period seems mandatory.

The remarkable increase in the number of chronic diseases and failing in the definite treatment of these illnesses in order to meet the needs of these patients as well as the high costs of control and management of these diseases require special attention to the promotion of health in them. The first step in planning for this promotion is a study of the factors inflouencing health promotion in order to use them in planning to control and manage chronic diseases. Granded theory is a powerful research method to study social structures and processes. This method was employed in the present research to collect and analyze the data in chronic patients. Semi-Structured interviews were used to collect the data which were analyzed using continuous comparison method. Six main themes including the meaning of health, life style, individual factors, spiritual beliefs, support and education emerged, all of which were effective in the process of health promotion in these patients. The findings indicated the concepts found in the research were interactively influencing each other to promote health in chronic patients. Support and education overshadowed other factors and had them under its influence. So, it is necessary to emphasise the role of these two factors in health-promoting activities in chronic patients and leading the patients towards health promotion through increasing self-reliance and creating a supportive environment.

Today, with changes in health care systems, most of the patients, receive occupational and special cares at home after being discharged from hospital. The aim of this study was to assess the effects of follow up on physical and emotional status of the patients with recent myocardial Infarction. This experimental study was done on 60 patients with acute myocardial infarction, who referred to Boali Hospital during 2000-2001.The patients were chosen randomly and were set in two different groups with 30 subjects in each group. Then, a home care program was designed for case group. but there was no intervention for control group. This home care program was completed and one week later the physical and emotional status of the patients in two groups were analyzed by Spilbergar and Beck tests and finally the results were compared in two groups using X2 test. The X2 test showed that there is a significant difference between resting heart rate of two groups with P<0.05 but the difference among systolic and diastolic blood pressure, body weight, anxiety and depression was not statistically significant in two groups. Regarding the effects of follow-up on the physical and emotional status of the patients, nurses can improve the quality of the patienys life through active home - care and rehabilitation programs along with social supports.