fatemeh heydarpour
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Background
Coronary endarterectomy is an adjunctive treatment to coronary artery bypass grafting (CABG)in patients with multiple coronary involvements. The aim of the present study was to compare the efficacyand safety of the rivaroxaban versus warfarin in patients undergoing CABG endarterectomy in a prospectiveobservational study.
MethodsAll the patients who had undergone CABG endarterectomy and had received rivaroxaban or warfarinduring the period from January2019 until August 2021 were included in the study. Need for salvage CABG,major bleeding, and thromboembolic events were considered as primary outcomes. The secondary outcomesincluded all-cause mortality and minor bleeding. All patients were followed for at least six months after theirhospital discharge.
ResultsOut of the 73 patients recruited during the 18 months, 45 received rivaroxaban and the remainingpeople received warfarin along with at least one antiplatelet. During the follow-up, no salvage CABG wasperformed. The minor bleeding was comparable between the two groups (31.96 versus 13.27; p=0.21). Therewas no significant difference between warfarin and rivaroxaban in terms of major bleeding and thromboembolicevents (p=0.38 and >0.99, respectively). The all-cause mortality rate was similar between the two groups(p>0.99).
ConclusionIn this preliminary real-word study, rivaroxaban was comparable to warfarin in terms of efficacyand safety in the patients undergoing CABG endarterectomy. Further larger studies are needed to clarify safetyand efficacy of such approach.
Keywords: Coronary Artery Bypass Grafting, Endarterectomy, Rivaroxaban, Warfarin -
زمینه
اثربخشی مشابهی از ریواروکسابان و وارفارین در حوادث ترومبوامبولیک در کارآزمایی های بالینی مشاهده شده است. اما مطالعات کمی در رابطه با مقایسه این داروها در دنیای واقعی وجود دارد. این مطالعه با هدف مقایسه ایمنی و اثربخشی ریواروکسابان و وارفارین طراحی شد.
مواد و روش هاتمام بیماران دریافت کننده ریواروکسابان یا وارفارین از تاریخ اردیبهشت ماه 98 تا مهرماه 99 وارد این مطالعه شدند. وقوع خونریزی های شدید و حوادث ترومبوامبولیک به عنوان پیامد اولیه در نظر گرفته شد. مرگ ومیر به هر علتی وخونریزی های خفیف به عنوان اهداف ثانویه در نظر گرفته شد. همه بیماران به مدت شش ماه پس از ورود به مطالعه و در پایان مطالعه پیگیری شدند.
یافته هااز 242 بیمار وارد شده در طی مدت شش ماه، 116 بیمار ریواروکسابان و 126 بیمار وارفارین دریافت نمودند. اگرچه خونریزی های شدید در گروه وارفارین بیشتر بود ولی تفاوت معناداری در رابطه با این خونریزی ها (0/24=p) و حوادث ترومبوامبولیک (0/38=p) بین وارفارین و ریواروکسابان دیده نشد. خونریزی های خفیف در گروه وارفارین به طور چشمگیری بیشتر بود (29/36 درصد در مقایسه با 12/93 درصد، 0/002=p). میزان مرگ ومیر به هر دلیلی بین دو گروه مشابه بود (0/67=p). بیش از 12 درصد از بیماران، ریواروکسابان را به دلیل قیمت بالای آن قطع کردند. در گروه وارفارین 14/28 درصد از بیماران به علت نوسانات آزمایشگاهی و دسترسی نامناسب به دارو، به درمان پایبندی نداشتند.
نتیجه گیریدر مطالعه حاضر، وارفارین و ریواروکسابان اثربخشی و ایمنی مشابه داشتند. همچنین پایبندی مناسبی در دو گروه مشاهده شد.
کلید واژگان: ریواروکسابان, وارفارین, فیبریلاسیون دهلیزی غیر دریچه های, ترومبوامبولیBackgroundThe similar efficacy of rivaroxaban and warfarin in thromboembolic events was recognized in clinical trials. But there are a few studies about the comparison of these medications in real world. This study was designed with the aim of comparing the efficacy and safety of the rivaroxaban and warfarin.
Materials and MethodsAll patients who received rivaroxaban or warfarin during April 2019 and October 2020 were recruited in the study. The major bleeding and thromboembolic events were considered as primary outcomes. Secondary outcomes were all cause mortality and minor bleeding. All of patients were followed for six months after recruitment and the end of study.
ResultsOf 242 patients recruited during the 18 months, 116 patients received rivaroxaban and 126 received warfarin. There were no significant differences between warfarin and rivaroxaban regarding major bleeding (p=0.24) and thromboembolic events (p=0.38). The minor bleeding was significantly higher in warfarin group. (29.36% versus 12.93%, p=0.002). The all-cause mortality rate was similar between two groups (p=0.67). More than 12% of patients were discontinued rivaroxaban, due to high cost. In warfarin group, 14.28% patients did not have compliance due to laboratory fluctuations and inappropriate access to medication.
ConclusionIn the present study, warfarin and rivaroxaban had similar efficacy and safety. In addition, suitable compliance was observed in both groups.
Keywords: Rivaroxaban, Warfarin, Non-valvular atrial fibrillation, thromboembolism -
Background
Cystic echinococcosis (CE) is one of the most important parasitic infections in subgroup seven common neglected diseases of humans and animals. It is in the list of 18 neglected tropical diseases of the WHO. We aimed to analyze the situation of the disease in Iran using Geographical Information System (GIS) and satellite data analysis.
MethodsThe data obtained from the Ministry of Health and Medical Education, Tehran, Iran and other related centers from 2009 to 2018 were analyzed using GIS. Then, the spatial distribution maps of the disease were generated, and the hot spots of the disease in Iran were determined using spatial analysis of ArcGIS10.5 software. Geographically weighted regression (GWR) analysis in ArcGIS10.5 was used to correlate the variables affecting the disease including temperature, relative humidity, normalized different vegetation index (NDVI) and incidence of hydatidosis. Data analysis was performed by Linear regression analysis and SPSS 21 software using descriptive statistics and chi-square test.
ResultsZanjan, Khorasan Razavi, North Khorasan, Chaharmahal Bakhtiari, Hamedan, Semnan, and Ardabil provinces were the hot spots of CE. The results of geographical weighted regression analysis showed that in Khorasan Razavi, North Khorasan, Chaharmahal Bakhtiari, Hamedan, Semnan, Ardabil, Zanjan, Qazvin, and Ilam provinces, the highest correlation between temperature, humidity, vegetation density and the incidence of hydatidosis was observed (P<0.001).
ConclusionThe use of maps could provide reliable estimates of at-risk populations. Climatic factors of temperature, humidity, NDVI had a greater impact on the probability of hydatidosis. These factors can be an indicator used to predict the presence of disease. Environmental and climatic factors were associated with echinococcosis.
Keywords: Hydatidosis, Incidence, Environmental varia-bles, Geographical infor-mation system, Iran -
The use of herbs during pregnancy is on the rise today, but some of these plants can not only cause side effects in the mother and fetus but also have drug interactions. This systematic survey and meta-analysis reading were administered to define the outbreak of herbs used by women during pregnancy. The present work was performed using the meta-analysis method from March 2000 to February 2019. The search process was carried out in Iranian databases such as SID, Regional Information Center for Science and Technology (RICST), Mag-Iran, IranDoc, Barakat Knowledge Network System, Iranian National Library and international databases such as PubMed / Medline, Cochrane Library, Scopus, Science Direct, Web of Sciences, Embase, EBSCO, and Google Scholar. keywords including medicinal herbs, Medicinal plant, Plant, Extract, Women, and pregnancy. The heterogeneity of investigations was scrutinized using the I2 index. Analysis was carried out using Comprehensive Meta-Analysis software. A total of 73 articles were contained in the meta-analysis process. Based on the results, the general outbreak of medicinal herbs use during pregnancy was 32.4% (95% CI: 28.2%-36.8%). The results of meta-regression showed that increasing in sample size leads to decreased overall prevalence of herbal medicine consumption during pregnancy and increasing in the year of research leads to increased overall prevalence of herbal drug use during pregnancy, which both were statistically significant (P <0.05).The prevalence of medicinal herbs consumption during pregnancy is relatively high.
Keywords: Herbal medicine, pregnancy, Women, Prevalence, Systematic Review -
Contrast-induced nephropathy (CIN) is the third cause of hospital-acquired acute kidney injury. The CIN prophylactic strategies adopted to date, although not highly efficient, are mostly based on antioxidant activity and hydration therapy. This study was designed and conducted to evaluate crocin’s efficacy in the prevention of CIN in chronic kidney disease (CKD) patients undergoing coronary angiography/angioplasty. In this randomized clinical trial, a total of 110 eligible CKD stage 3 patients requiring contrast agent administration for coronary angiography/angioplasty were enrolled and randomly assigned to either crocin (n = 57) or control (n = 53) group. The patients in both groups received standard hydration therapy; nevertheless, in the crocin group, the patients were also orally administered three consecutive oral doses of 30 mg crocin tablets 1 day before up to 1 day after contrast media (CM) exposure. The primary endpoint was CIN incidence defined as an increase in serum creatinine (SrCr) level by ≥ 0.3 mg/dL or any change in urinary neutrophil gelatinase-associated lipocalin (NGAL) from the baseline within 48 hours of CM exposure. During 4 months, 130 patients were recruited. The mean age of the patients was 65.62 ± 9.05 years, and the majority of them were male (64.54%). The SrCr in the crocin group did not significantly increase within 48 hours of angiography/angioplasty. The changes in the urinary NGAL level were not significant in both groups. The CIN incidence was significantly lower in the crocin group than in the control group (1.75% and 13.2%; P = 0.028). Crocin administration plays an important nephron-protective role in the prevention of CIN.
Keywords: NGAL, Contrast-Induced Nephropathy, Crocin, Angiography, Acute Kidney Injury -
Background
Although corticosteroids are commonly used for COVID-19 disease during the inflammatory phase, the effective doses and the best choice of corticosteroids are not yet known.
MethodsIn the present study, the effects of non-pulse (30-250 mg/day of prednisolone equivalent) versus pulse equivalent (>250 mg/day of prednisolone equivalent) doses of corticosteroids are compared in terms of the patients’ oxygen saturation, hospital mortality, and side effects. In addition, the patients were followed for 2 months for readmission and mortality.
Results270 severe or critically ill patients with COVID-19 disease were included in the study. Diabetes and hypertension were the most common comorbidities. More than 80% of the patients received corticosteroids. Pulse equivalent doses of corticosteroids were used in 36.9 % of the patients. Treatment with pulse doses of corticosteroid significantly increased the oxygen saturation in the critically ill patients. However, the pulse doses significantly increased the in-hospital mortality rate [29 (20.3%) vs. 12 (10.6%), p=0.036] and the side effects. In addition, a trend toward higher 60-day mortality was observed in the pulse-based-treated patients [31 (21.7%) vs. 14 (12.4%), p=0.053]. The multivariate analysis showed that having comorbidities increased the mortality risk independently [OR 3.33, CI 1.148-9.647].
ConclusionThe results showed that the pulse doses of corticosteroids increase the oxygen saturation, but they also can increase mortality. Further randomized controlled trials with larger sample sizes are needed to confirm our findings.
Keywords: Drug Therapeutic Index, Corticosteroids, COVID-19 -
With regard to the importance of prescribing medicinal plants in the traditional veterinary medicine and the anti-inflammatory role of ginger, the current study was conducted to evaluate the effects of the oral administration of the ginger rhizome powder following ovariohysterectomy in puppies. Ten healthy young female puppies were randomly assigned to two equal groups, including a control and an experimental group. Two hours before surgical neutering by ovariohysterectomy, a Zintoma Capsule (Zingiber officinale) was administered orally in the experimental group and continued daily for 10 days after surgery. Several inflammatory markers were measured to evaluate the postsurgical status of the animals in the different times. Although there was no difference in the albumin and glucose level between the experimental and control groups at the different times, a statistically significant reduction in the inflammatory markers C-reactive protein (CRP), fibrinogen, tumor necrosis factor a (TNF-α), and interleukin 6 (IL-6) was observed in the experimental group compared to the control group. These preliminary findings suggest the usefulness of ginger rhizome powder, a traditional herbal dietary supplement, in the reduction of postoperative inflammatory reactions in dogs undergoing ovariohysterectomy.Keywords: Dog, ginger, Ovariohysterectomy, Postoperative inflammation indices
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زمینه و هدف
استرس شغلی یکی از پدیده های مهم در زندگی اجتماعی و تهدیدی جدی برای سلامتی نیروی کار در جهان است. استرس شغلی علاوه بر تاثیر منفی برسلامت جسمی میتواند باعث کاهش ملاحظات اخلاقی نیز شود. بنابراین هدف از انجام این مطالعه ضمن بررسی علل ایجاد استرس شغلی در پرسنل درمانی شاغل در اورژانس بیمارستان طالقانی و تاثیر آن بر ملاحظات اخلاقی آنها سال 1398 انجام شد.
روش بررسیمطالعه حاضر توصیفی- تحلیلی از نوع مقطعی بوده و کل پرسنل پرستاری شاغل در بخش اورژانس بیمارستان طالقانی کرمانشاه 45 نفر بودند که به روش سرشماری انتخاب شدند. شدت استرس و عوامل مرتبط با آن از طریق پرسشنامه پژوهشگر ساخته انداره گیری شد و جهت ساخته شدن این ابزار چندین پرسشنامه مرتبط با موضوع شامل پرسشنامه استاندارد شده استرس شغلی (HSE) و پرسشنامه استاندارد استرس شغلی اسیپو استفاده گردید.. در تجزیه و تحلیل داده ها از روش های آمار توصیفی و استنباطی برای ارتباط بین متغییر های تحقیق استفاده شد.
یافته هادر بررسی نمره کلی پرسشنامه با استرش ناشی از شغل در اورژانس بیمارستان طالقانی کرمانشاه مشاهده شد که 3 نفر دارای استرس شدید، 17 نفر استرس متوسط تا شدید و 25 نفر(55.5%) استرس کم تا متوسط هستند. ارتباط معناداری بین میزان استرس شغلی تجربه شده و جنس و سن پرسنل وجود داشت (p<0/ 05) به طوریکه زنان پرستار و نیز کارکنانی که دارای سن و سابقه کار کمتری بودند شدت استرس بالاتری را تجربه میکردند.
نتیجه گیریتاثیر استرس شغلی بر ملاحظات اخلاقی پرسنل درمانی شاغل در اورژانس بیمارستان طالقانی کرمانشاه از نظر آماری معنی دار می باشد. بنابراین، برای مدیران ضروری است که با به کار گیری راه کارهای حمایتی از تاثیرات دراز مدت استرس شغلی بر کارکنان این حرفه که تعداد آنها در جامعه کنونی با توجه به نیازهای جامعه رو به افزایش است پیشگیری کنند.
کلید واژگان: استرس شغلی, ملاحظات اخلاقی, پرسنل پرستاری بخش اورژانسBackground and AimJob stress is an important social phenomenon and a serious threat to the health of the manpower around the world. In addition to its negative effects on physical health, job stress can undermine the ethical considerations. Therefore, the aim of this study was to find the causes of job stress in the medical staff working in the emergency department of Taleghani Hospital and its effect on their ethical considerations.
MethodsThis descriptive-analytical study was conducted on the nursing staff (n=45) of the emergency department of Taleghani hospital, who were selected by convenience sampling. The severity of stress and factors associated with it were measured by a researcher-made questionnaire. To construct this questionnaire, several questionnaires related to the research topic, including Health and Safety Executive (HSE) survey and Osipow Job Stress questionnaire were used. Data were analyzed by descriptive and inferential statistics.
ResultsThe results showed that 3 nurses had severe stress, 17 had moderate to severe stress, and 25 (55.5%) had low to moderate stress. No significant relationship was observed between the experienced job stress and the staff’s gender and age (p<0.05) so that the female nurses and the staff with a lower age and work experience underwent a higher level of stress.
ConclusionJob stress had a significant effect on the ethical considerations of the staff of the emergency department of Taleghani hospital. Hence, the managers are required to employ supportive strategies to prevent the long-term effects of job stress on these staff, whose number is currently increasing owing to the needs of the society.
Keywords: Job stress, ethical considerations, nursing staff of emergency department -
Background
Human hydatidosis as a public concern has increased in a number of countries that have reduced control programs for the disease due to lack of resources or policies. We aimed to estimate Disability-Adjusted Life Years (DALYs) for human hydatidosis in Iran in 2018.
MethodsData were collected from the Center of Communicable Diseases Control, Ministry of Health &Medical Education, Tehran, Iran in 2018. To calculate DALYs, years of life lost due to premature death (YLL) with years of life with disability (YLD) were calculated according to the formula as DALY = YLL + YLD. The standard life expectancy lost method (SEYLL) was used to calculate the years lost due to premature death.
ResultsDALYs for human hydatidosis was calculated as 1210.12 years (YLD equals to 177.12 and YLL equals to 1033) in Iran for the year 2018. It was estimated to be 700.2 years for men and 509.8 years for women. DALYs in men were significantly different from women (P= 0.001) so DALYs were more in men than women were. YLD was calculated at 78.228 years in men and 98.892 years in women and in both men and women at 177.12 years. YLD was significantly different in women compared to men (P=0.001), so YLD in women was more than in men.
ConclusionWe reached considerable indices for hydatidosis in our study. Therefore, disease prevention and control programs in Iran seem necessary by the policy makers.
Keywords: Hydatidosis, Burden, Disability-adjusted life years, Human, Iran -
Background
Direct oral anticoagulants (DOACs) are increasingly used due to fewer side effects, predictable pharmacokinetics, lower potential for drug interactions. Different levels of awareness among health care professionals have been reported.
MethodsThe main objectives of this study were to investigate the knowledge and attitude of pharmacists about direct oral anticoagulants. The present study was a descriptive cross-sectional study performed in Kermanshah province, Iran. The validated researcher-made questionnaire included questions about demographic characteristics and specialized questions that assessed the knowledge and attitude of pharmacists towards new oral anticoagulants.
ResultsOut of 126 pharmacists participating in this study, 67 (53.2%) were male. The mean scores of knowledges and attitude in pharmacists were 64.94±5.84 and 28.62±3.98, respectively. The most common oral anticoagulant with a direct effect dispensed by pharmacists was rivaroxaban (77.4%). There was also a significant relationship between pharmacists' attitudes and their place of activity (P = 0.024).
ConclusionThe results of this study showed that pharmacists had an acceptable knowledge and low attitude about DOACs.
Keywords: Attitude, Direct Oral Anticoagulants, Knowledge -
زمینه و هدف
اضطراب یکی از شایع ترین علایم همراه در مادران بارداراست و با عواقب ناگوار مادری و نوزادی همراه است، مطالعه حاضر با هدف تعیین تاثیر مشاوره مبتنی بر ذهن آگاهی بر اضطراب بارداری و پارامترهای فیزیولوژیک نوزادان انجام شد.
مواد و روش هااین مطالعه به روش شبه تجربی و با استفاده از طرح پیش آزمون –پس آزمون با گروه کنترل انجام شد. 60 زن باردار نخست زای مراجعه کننده به مراکز بهداشتی درمانی شهر کرمانشاه به شیوه در دسترس انتخاب و به صورت تصادفی در گروه مداخله و کنترل تخصیص یافتند. گروه کنترل مراقبت های معمول بارداری و گروه مداخله علاوه بر مراقبت های معمول بارداری، هشت جلسه 60 تا 90 دقیقه ای مشاوره مبتنی بر ذهن آگاهی دریافت کردند. قبل، بلافاصله بعد و یک ماه پس از مداخله پرسشنامه اضطراب بارداری وندنبرگ توسط هر دو گروه تکمیل شد. بعد از زایمان چک لیست پارامترهای فیزیولوژیک (وزن، قد، سن بارداری و نمره آپگار) نوزادان مادران هر دو گروه تکمیل شد. یافته ها پس از ورود به نرم افزار SPSS نسخه 25 مورد تجزیه وتحلیل قرار گرفت.
یافته هااضطراب بارداری قبل از مداخله بین دو گروه مداخله و کنترل از نظر آماری تفاوت معنادار نداشت (0/694=P) ولیکن در بلافاصله بعد و یک ماه بعد از مداخله تفاوت معنادار بود (0/001 <P). پارامترهای فیزیولوژیک نوزادان متولدشده از زنان گروه مداخله و کنترل در بعد از زایمان تفاوت معناداری نداشت.
نتیجه گیریبر اساس نتایج مطالعه مشاوره مبتنی بر ذهن آگاهی در کاهش اضطراب بارداری موثر بود ولیکن تاثیری بر پارامترهای فیزیولوژیک نوزادان در هنگام تولد نداشت.
کلید واژگان: اضطراب, بارداری, پارامترهای فیزیولوژیکScientific Journal of Nursing, Midwifery and Paramedical Faculty, Volume:6 Issue: 1, 2020, PP 106 -116Background & AimAnxiety is one of the most common accompanying symptoms in pregnant mothers and is associated with adverse maternal and neonatal consequences. The aim of the present study was to examine the impact of mindfulness-based counseling on the levels of anxiety during the pregnancy period and on newborns’ physiological parameters.
Materials & MethodsThis study was a semi experimental pretest-posttest with a control group. Sixty primiparous pregnant women who referred to the health clinics of Kermanshah were selected using convenient sampling and were randomly assigned into either experiment or control group. The control group received routine prenatal care, and the experimental group underwent eight groups mindfulness-based counseling sessions (60-90min) twice a week, in addition to routine prenatal care. Before, immediately after and one month after the intervention, both groups completed the Vandenberg Gestational Anxiety Questionnaire. In addition, after delivery, the newborns’ physiological parameters (weight, height, gestational age and Apgar score) checklist was completed. The data was analyzed using Mann-Whitney, Independent t-test, and Friedman's tests using SPSS- 25.
ResultsPregnancy anxiety was not significant between the control and intervention groups before the intervention (p = 0.694). However, immediately and one month after the intervention the difference was significant (p≤ 0.001). After delivery, the physiological parameters of infants born to women in the intervention and control groups were not significantly different.
ConclusionAccording to the study results, mindfulness-based counseling was effective in reducing pregnancy anxiety, but did not affect the physiological parameters of newborns at birth.
Keywords: pregnancy, anxiety, physiological parameters -
BackgroundUndesirable health outcomes of anemia impact all different groups of people within a society especially pregnant women (PW).ObjectivesThis study aimed to evaluate other fetal and maternal complications of anemia in various trimesters of pregnancy.MethodsA large retrospective cohort study was conducted on Iranian PW in 2017. The first and third trimesters of pregnancy were assessed as a separate study. The first study included 1038 anemic and 2463 non-anemic PW and the second comprised 756 anemic and 1986 non-anemic PW. The outcome-related pregnancies were analyzed for each study.ResultsAfter adjusting for the potential confounding factors, the odds of neonatal mortality (OR = 1.63; CI 95%, 1.25 - 2.13) were significantly higher and the odds of cesarean delivery (OR = 0.6; CI 95%, 0.46 - 0.75) were significantly lower in women who had anemia during the first trimester. The chance of pre-term delivery (< 37 weeks; OR = 2.15; CI 95%, 1.6 - 2.91) and abortion (OR = 1.68; CI 95%, 1.11 - 2.53) was significantly higher in women who had anemia during the third trimester, while the chance of low birth weight (< 2500 kg) (OR = 0.66; CI 95%, 0.46 - 0.93) was lower in anemic women during the third trimester than in those without anemia.ConclusionsPregnant women who experience anemia in both first and third trimesters of pregnancy have different unpleasant pregnancy outcomes. Since anemia is preventable during pregnancy, many of these outcomes such as neonatal mortality, low birth weight, preterm and cesarean delivery, and abortion could be prevented and decreased by providing health education before pregnancy.Keywords: Neonatal Mortality, Anemia, Retrospective Cohort Study, Iran
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BackgroundDyslexia refers to children's disorder in reading. The most psychologists consider dyslexia merely as a sign of a special disorder in the process of reading instruction which is an important factor to lower the confidence of these children. We aimed to investigate the relationship between attachment styles and parenting styles with self-esteem in elementary dyslexic girl students.Materials And MethodsAt a cross-sectional study, the study samples included elementary dyslexic girl students in Kermanshah Center of Learning Disorders No.2, Kermanshah city (Iran); and 116 elementary dyslexic girl students selected by available sampling method. The tools used in this study included Cooper's Self-esteem questionnaire, Attachment Scale (RASS), and Parenting Styles Questionnaire. Children completed the self-esteem and attachment scale questionnaires and parents answered the parenting styles scale. Data were analyzed using SPSS software version 22.0ResultsThe mean of self-esteem in elementary dyslexic girl students was 28.84±13.06 (ranged 0-50), attachment styles were 27.87 ± 6.41(ranged 0-90), and parenting styles were 29.12 ± 8.67 (ranged 0-150). There was a significant positive correlation between self-esteem with ambivalent attachment style (r=0.28), and easy-going parenting styles (r=0.27), and rational authority parenting styles (r=0.21) at level pConclusionAccording to the results, there was a positive correlation between ambivalent attachment style, easy-going parenting styles and rational authority with self-esteem, and these variables have the ability to predict self-esteem in elementary dyslexic girl students.Keywords: Attachment Styles, Children, Dyslexia, Self, Esteem, Parenting Styles
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BackgroundInjection drug use (IDU) is one of the most dangerous and addictive methods of drug abuse. The current statistics showed that the rate of IDU is increasing, and is higher compared to other methods of drugs abuse. In addition, it is one of the main routes of transmitting infectious diseases, such as human immunodeficiency virus (HIV) and hepatitis in Iran.ObjectivesIn light of this, the present study aimed at examining the main factors, affecting the tendency for IDU. Patients and Methods: This study was a descriptive study of 823 individuals, having an active file at centers and referred to Kermanshah-based maintenance methadone therapy (MMT) centers, in 2015. Sample collection was performed through multi-stage sampling of all MMT centers. Information gathering was performed with the help of a Psychologist of the ward, in charge of interviewing the referees. The data were analyzed, using multi-variable logistic regression.ResultsAll the clients were males with an average age of 38.48 ± 11.21 years. Average age of drug abuse initiation was 23.03 ± 7.9 years. After controlling for confounding variables, the individuals, who were a drug addicts for more than 10 years had 3.01 (1.6 to 5.6) times greater tendencies for intravenous drug addiction, compared to those, who were a drug addict for less than five years. In addition, individuals aged more than 35 years had 0.06 (0.01 - 0.22) times less tendencies to IDU drugs, compared to those, who were younger than 19 years old. Although the type of drug that the patient used for the first time, was not affecting the tendency, the risk of intravenous drug addiction in those, who used oral drugs was 1.74 (1.1 to 2.56) times more than those, who developed a drug addiction through nasal drugs.ConclusionsBy taking into consideration that drug abuse initiation and the duration of drug use were the main causes of the tendency for IDU, prevention by decreasing the age of the development of drug addiction and decreasing the duration of drug use, could be an effective measure to decrease the rate of IDU in the society.Keywords: Addiction, Injection, Methadone
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Dogs as a valuable large animal model display important roles for investigation of diagnosis and treatment of different disorders of human diseases such as pain relieving procedures. Analgesic efficacy of preoperative administration of piroxicam, ketamine and lidocaine combined with local anesthesia for management of intra and early post-operative pain in the three equal groups of dogs undergoing bone marrow aspiration was evaluated in twenty-four immature female stray dogs that had been referred for FNA technique. Some clinical, physiological and biochemical parameters of the animals were studied before and during the three hours after the BMA. In the ketamine group, hyperglycemia was found to be less than piroxicam and lidocaine groups. A maximum increase of heart rate and respiratory rate was recorded 0.5 h after premedication in all the groups and these variations were significantly recorded in the piroxicam group. Immediately after FNA, clear increments of rectal temperature, especially in the piroxicam group, were also seen in all used drug groups. Evaluation of sedation and analgesia results of the present study indicated no analgesic effect of piroxicam in bone marrow FNA and minor sedative effect just immediately before aspiration. Ketamine with its analgesic nature provided more sedation and adequate pain relief due to FNA technique rather than other groups. Therefore, pain therapy can be improved using preoperative sub-anesthetic dose of ketamine combined with local anesthesia for bone marrow FNA in dogs.Keywords: Preemptive Analgesia, Piroxicam, Ketamine, Lidocaine
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زمینهکم خونی فقر آهن که شایعترین مشکل کم خونی تغذیه ای در سطح جهان می باشد عارضه ای چند عاملی است و پیامدهای نامطلوب اقتصادی و اجتماعی را به جوامع تحمیل می نماید. مطالعه حاضر با هدف تعیین شیوع کم خونی، کمبود آهن و عوامل موثر برآن در دانشجویان دختر انجام گرفت.روش هادر این مطالعه مقطعی 310 نفر به روش تصادفی انتخاب شدند. ابزار گردآوری اطلاعات پرسشنامه های دموگرافیک، افسردگی بک، فعالیت فیزیکی و بسامد خوراکی بود. ترکیب بدن با استفاده از دستگاه Body Analyzerاندازه گیری شد و برای تعیین وضعیت پارامترهای خونی مقدار 5 میلی لیتر خون از شرکت کنندگان اخذ شد.یافته ها44%دانشجویان فریتین کمتر از 20(کمبود آهن)، 8/9% هموگلوبین کمتر از 12 (کم خونی) و 8/6% هموگلوبین کمتر از 12 و فریتین کمتر از 20 (کم خونی ناشی از کمبود آهن) داشتند. 3/26% از دانشجویان مبتلا به افسردگی بودند. کمبود آهن با میزان مصرف گروه گوشت ها ارتباط معنادار داشت، به این صورت که با افزایش هر واحد به گروه گوشت ها، شانس ابتلا به کمبود آهن 4/2 برابر کاهش می یافت (94/0-65/0CI:، 976/0OR=). میزان فریتین با موفقیت تحصیلی ارتباط معنی دار داشت(04/0P=).نتیجه گیریشیوع بالای کمبود آهن و کم خونی در این مطالعه موید عدم تعادل بین دریافت آهن از رژیم غذایی با نیازهای دختران می باشد که مستلزم توجه بیشتر به این گروه می باشد.
کلید واژگان: کم خونی, کمبود آهن, تغذیه, افسردگیBackgroundIron deficiency anemia is the most common nutritional problem in the world is a complicated and multifaceted economic and social consequence to the community to impose. This study aimed is to determine the prevalence of anemia, iron deficiency and factors that effect on it among female studentsMethodsThe study population was 310 female students of medical science university of Kermanshah that samples were selected randomly from it. The tools of data collection were demographic; Beck, FFQ and WHOQOL-BREEF.5 ml blood was gathered from pioneer samples for determination of blood parameters and was investigated by standard laboratory methods.Results44% of students had ferritin < 20 (iron deficiency), 9.8% hemoglobin <12 (anemia) and 6.8% of them had hemoglobin <12 and ferritin < 20 (iron deficiency anemia). 26.3% of students were depression. Iron deficiency was significantly associated with the consumption of meat, this is the increase per unit of meat, the chances of an iron deficiency 2.4 times decreased (OR=0.976, CI=0.65-0.94). Ferritin levels were significantly associated with academic success (P=0.04).ConclusionHigh prevalence of iron deficiency and iron deficiency anemia in this study can show the imbalance between girl's intake of iron and their needs required further attention to this group.Keywords: Anemia, Iron deficiency, Nutrition, Depression -
زمینه و هدفزمان مورد نیاز برای حاملگی خواسته (TTP) Time to pregnancyنامیده می شود. عوامل موثر بر TTP به دلیل تفاوت در شیوه زندگی و موقعیت جغرافیایی ممکن است در کشورها و مکان های مختلف متفاوت باشد. لذا این مطالعه با هدف تعیین عوامل موثر بر طول مدت زمان تا بارداری (TTP) در شهرستان کرمانشاه سال 1390 انجام شد.
روش کاردر این مطالعه مورد- شاهدی 174 مادر با TTP بیشتر از 12 ماه و 587 مادر با TTP مساوی و کمتر از 12 ماه به ترتیب به عنوان گروه مورد و شاهد انتخاب شدند. ابزار گردآوری اطلاعات پرسشنامه بود تجزیه و تحلیل با استفاده ازنرم افزار SPSS16 انجام شد و 05/0>p به عنوان سطح معنادار آماری در نظرگرفته شد.نتایجنتایج آنالیز چند متغیره نشان داد سواد زن (دیپلم و بالاتر) (984/0-741/0= 95%CI، 854 /0=OR)، افزایش دفعات نزدیکی در هفته (839/0- 631/0=95% CI، 728/0= OR)، عدم قرارگیری در معرض دود مواد دخانی (965/0-380/0=95%CI، 606 /0= OR) و داشتن گروه خونیA نسبت به O (01/1-405/0=95% CI، 639/0= OR) و نداشتن سابقه بیماری زن (774/0-350/0=95%CI،520/0=(OR به طور معناداری شانس زمان تا باردار شدن را کاهش و BMIبیش از25 کیلوگرم بر متر مربع (312/3-489/1=95% CI، 221/2=OR)، قاعدگی نامنظم (441/6-127/2=95%CI،701/3=OR) و عدم انجام فعالیت های ورزشی زن (918/2-263/1=95%CI، 920/1=OR) و داشتن سلبقه بیماری واریکوسل در مرد (739/17-600/2=95%CI،792/6= (ORشانس زمان تا بارداری را افزایش می دهند.نتیجه گیریبراساس نتایج این مطالعه، عواملی از قبیل BMI بالا و عدم انجام فعالیت های ورزشی زن شانسTTP را افزایش و عواملی از قبیل افزایش تعداد نزدیکی در هفته شانس آنرا کاهش دادند. زوجینی که بدنبال حاملگی هستند و بدنبال مداخلات پزشکی می روند معمولا عوامل مرتبط با TTPرا مد نظر قرار نمی دهند. توصیه می شود مراقبین بهداشتی از این زوجین حمایت کنند و به آنان آموزش و مشاوره لازم را بدهند.
کلید واژگان: زمان تا باردار شدن (TTP), کم باروری, عوامل موثر, کرمانشاهBackground And AimThe time needed to achieve a wanted pregnancy is referred to as time to pregnancy (TTP). Due to differences in lifestyles and geographical locations in different countries, factors affecting TTP may be different in various countries. This study was conducted in 2011 to determine factors affecting time to TTP in Kermanshah, Iran.Materials And MethodsIn this case-control study 174 women with TTP>12 months (cases) and 587 women with TTP<=12 months (controls) were selected. The tool for collecting data was a questionnaire. The SPSS-16 software was used for data analysis, a p-value <0.05 being considered as statistically significant.ResultsMultivariate analysis showed that factors decreasing TPP statistically significantly were women's education level (≥high school diploma; OR=0.854, CI 95%=0.741-0.984), frequency of intercourse in a week (OR=0.728, CI95%=0.631-0.839), blood group A compared to O (OR=0.639, CI95%=0.405-1.01), and non-exposure to smoking (OR=0.606, CI95%=0.380-0.965). On the other hand, factors increasing TPP were a woman's irregular menstrual cycle (OR=3.701, CI95%=2.127-6.441), lack of physical activity (OR=1.920, CI95%=1.263-2.918) and a body mass index (BMI) higher than 25 (OR=2.221, CI 95%=1.489-3.312).ConclusionAccording to the results of this study, a high BMI and lack of exercise increase, while factors such as frequency of intercourse decrease the length of TTP. Couples seeking medical intervention for pregnancy often disregard factors associated with TTP. It is recommended that care-providers support these couples, promote their awareness, and give them suitable advice.Keywords: Time to pregnancy, subfertility, effective actors, Kermanshah -
این مطالعه تحلیلی عوامل مرتبط با تغذیه انحصاری با شیر مادر در مراکز بهداشتی-درمانی شهر کرمانشاه در سال 1386 را بررسی نمود. 168 مادر دارای کودک 12-6 ماهه با تغذیه انحصاری و غیرانحصاری بررسی شدند. جهت تجزیه و تحلیل داده ها از آمار توصیفی– تحلیلی استفاده شد. ابتلا به بیماری های تنفسی و گوارشی در شش ماه اول تولد در شیرخوار در گروه تغذیه انحصاری به طور معناداری کم تر و مدت شیردهی در زایمان قبلی در گروه تغذیه انحصاری بیشتر از گروه تغذیه غیرانحصاری بود. [(1/5=OR)، (4OR=)]. جنس شیرخوار، سواد، شغل و سن مادر و زمان شروع شیردهی بین دوگروه تفاوت معنادار آماری نداشت.
کلید واژگان: تغذیه انحصاری با شیر مادر, مراکز بهداشتی درمانی, شیر مادر, شیرخوارانThe present analytical study was designed to determine the factors associated with exclusive breastfeeding in primary health centers of Kermanshah in 2007. 168 mothers with infants aged 6-12 months, with or without exclusive breastfeeding were studied. Data analysis was carried out using descriptive and analytic statistics. In exclusive breastfeeding group the respiratory and gastrointestinal diseases in the first six months after birth were significantly lower than that in non exclusive breast feeding group. Also, in the first group the duration of breast feeding in previous child was higher than that in the latter group (OR=4 and OR=5.1, respectively).No association was found between exclusive breastfeeding and parameters such as child gender, education, job and age of mother and time of starting the breastfeeding.
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