فهرست مطالب mehdi birjandi

The prevalence rate of type 2 diabetes (T2DM) is increasing worldwide, and the role of diet in its etiology has been established. The Dietary inflammatory index (DII) has attracted significant attention in evaluating associations between diet and diseases due to the role of chronic inflammation as an underlying cause of numerous disease processes. Therefore, the relationship between DII score and the risk of T2DM is evaluated in the Iranian population for the first time.

113 newly diagnosed T2DM patients and 226 apparently disease-free control cases aged 23-59 participated in this case-control study. A valid semi-quantitative food frequency questionnaire was used to assess dietary intake. Then, energy-adjusted DII (E-DII) scores were computed and categorized into quartiles based on values in the population study. A logistic regression model was used to estimate the association between DII and the risk of T2DM after controlling for important potential confounders and effect modifiers.

A significant association was observed between E-DII score and T2DM in the crude model (P-trend<0.001), model I (adjusted for physical activity, gender, education level, and family history of T2DM, P-trend<0.001), model II (adjusted for model I + body mass index, P-trend=0.005) (ORquartile4vs1 =2.98 (95% CI: 1.18, 9.12; P= 0.005).

A direct association was observed between DII score and the risk of T2D, implying that consuming a more anti-inflammatory diet would help to prevent T2DM. Future longitudinal studies should be conducted to further explore this association.

The presence of microbial agents on different hospital surfaces is considered a harmful factor to health. The use of hypochlorous acid (HOCl) for health purposes has been evaluated in more than 50 countries. The present study aimed to assess the disinfection effect of Sanitizon solutions and common disinfectants (Sayasept HP and Sayasept 420) on the reduction of microbial load in Shohada-ye Ashayer Hospital, Khorram Abad.

In this experimental study, 200 samples from intensive care units were prepared and studied in seven experimental groups (one control group and six different types of disincentives) in six different hospital departments. The samples were cultured on specific culture media. The results were analyzed using SPSS software (version 23). The germicidal power of disinfectants was investigated according to standard 10504 and diffusion method in agar.

The use of disinfectants caused a significant decrease in the microbial load compared to the control group. Disinfection solutions led to a decrease in the number of colonies from 113 to 12. Moreover, all disinfectants had germicidal and fungicidal power according to the standard (reduction of four logarithms of bacteria). The Sanitizon solution succeeded in removing all microorganisms and reducing more than seven logarithms of test microorganisms. Sanitizon caused a more marked reduction of gram-negative bacteria and fungi compared to other disinfectants.

As evidenced by the results, Sanitizon can be used along with other common disinfectant products to clean surfaces. The intermittent use of disinfectants with different active substances reduces the probability of resistance in microorganisms.

HIV, HBV, and HCV are known as the most common blood-borne viral infections worldwide. Individuals referring to drop-in centers (DICs) are considered as high-risk people exposed to infection with theses blood-borne viruses. The purpose of this study was to investigate the prevalence of HIV, HBV, and HCV infections among women referred to DICs in the western province of Lorestan, Iran. During the present cross-sectional study, after obtaining informed consent and a questionnaire, two blood samples were collected from 118 women referred to Lorestan DICs to be evaluated for HIV, HBV, and HCV infections. Accordingly, the samples were first screened by using the most common serological methods, and then by Real Time-PCR to detect viral genomes. The results were analyzed using Chi-square statistical test and binary logistic regressions. Out of the studied 118 blood samples, 8 (6.8%), 4 (3.4%), and 10 (8.5%) subjects tested positive for HIV, HBV, and HCV infection, respectively. Furthermore, our study showed that 5 (4.2%) subjects were positive for HCV/HIV coinfection, and 3 (2.5%) cases for HBV/HCV coinfection. Moreover, our data revealed that incarceration and STDs were the most important risk factors for HIV (OR=15.27 (95% CI; 3.74 - 62.89); P value=0.01) and HBV (OR=16 (95% CI; 1.57 - 42.34); P value=0.018) infections, respectively. Our results suggest that women referring to DICs are at risk of infection with blood-borne viruses such as HIV, HBV, and HCV, due to risky behaviors. Thus, precise diagnostic testing and implementation of preventive methods against blood and sexually transmitted infections are urgent in these high-risk groups.

Polycystic ovary syndrome (PCOS) is an inflammation-related condition and a common metabolic disorder in women at fertility ages. The Dietary Inflammatory Index (DII) is a validated nutritional tool for estimating the inflammatory potential of the diet. It is assumed that a high DII score (indicating a predominantly inflammatory diet) has an association with higher odds of PCOS. The current study aimed to investigate the association between DII and PCOS risk in women. 

This case-control study was conducted in 2019-2020 on 120 newly-diagnosed PCOS cases and 120 healthy controls aged 18-45 years in Khorramabad, Iran. DII was estimated based on a validated 168-item Food Frequency Questionnaire (FFQ).

The mean±SD of DII in PCOS patients was 0.40±2.09, while it was 0.45±1.92 in the control group (P<0.001). There was a positive association between increasing DII score and the risk of PCOS (odds ratio= 2.41; 95%CI: 1.15-5.02, P for trend =0.006) in the crude model as the fourth quartile was compared with the lowest one. This association was still significant in several models after adjusting for age and energy intake (P for trend <0.001), in the model adjusted for the physical activity level, education status, and family history of PCOS (P for trend=0.003), and also after additional adjustment for BMI (P for trend= 0.003).

The present study revealed that consuming more pro-inflammatory diets with higher DII scores is related to an increased risk of PCOS.

 Co-infection of HBV and HDV leads to more severe hepatitis, with a higher risk of acute liver failure and hepatocellular carcinoma (HCC). This study aimed to assess the prevalence of HDV in HBsAg-positive patients in Khorramabad, which has not been previously evaluated.

 A total of 200 patients who tested positive for HBsAg were included in this study. Venous blood samples were collected in EDTA-free tubes. An ELISA test was performed to detect antibodies against HDV, and positive samples were further confirmed using RT-PCR. Population data were analyzed using SPSS software, and a P value ≤0.05 was considered statistically significant for all tests.

 Out of the total participants, there were 119 (59.5%) men and 81 (40.5%) women. The age of the patients varied from 5 to 89 years, with an average age of 49.66 years. The HDV ELISA test was performed on HBsAg-positive individuals, yielding positive results for 37 (18.5%) patients. Additionally, 10 (5%) patients showed borderline infection. The HDV RT-PCR results indicated that 42 (21%) individuals tested positive. The prevalence of HDV showed a statistically significant difference between urban and rural areas with respect to molecular RT-PCR testing (P=0.032). Additionally, women, married individuals, and drug addicts were found to be at a higher risk of HDV infection.

 There is a high prevalence of HDV infection among patients who test positive for HBsAg in Khorramabad. Therefore, assessing the prevalence of HDV in HBsAg-positive patients can aid in ensuring timely diagnosis and appropriate treatment for these individuals.

Due to the possible complications of a persistent ductus arteriosus (PDA), the treatment of the PDA will be necessary, depending on the opinion of the treating physician. Medical or surgical treatment can be used in this regard. In recent years, acetaminophen has been considered a medication with fewer potential side effects.  The present study aimed to compare acetaminophen with ibuprofen in the patent ductus arteriosus in neonates admitted to training hospitals in Khorramabad.

A total of 28 neonates were included in this retrospective cohort study. The required data were collected by studying the patients' files. The PDA in newborns was diagnosed by primary echocardiography by the attending physician. Thereafter, 12 and 16 cases were treated with ibuprofen and acetaminophen, respectively. After completing the treatment period on days 3 and 5, the attending physician performed echocardiography to check PDA closure. Data were analyzed in SPSS software (version 24) using descriptive indices of mean, standard deviation, frequency, percentage, Fisher's exact test, and Mann-Whitney U test.

In this study, the frequency of affected male neonates was the same as that of affected female newborns (n=14; 50%). The mean weight scores of neonates in acetaminophen and ibuprofen groups were obtained at 2831/25±918/49 and 2241/5 ±868/9 gr, respectively. All newborns in both groups were treated; thereafter, 23 cases recovered with 3-day treatment and 5 neonates with 5-day treatment. No significant complications were observed in patients.

The effect of acetaminophen on PDA closure was similar to that of ibuprofen. The need for 5-day treatment was higher in the acetaminophen group; nonetheless, no significant side effects were reported in any newborn. According to this study, acetaminophen can be a good alternative to ibuprofen in the treatment of PDA.

The "family physician" program is one of the plans which aimed at expanding the coverage of insurance, overcoming the barriers to the health system of the country, and solving the public health problems in Iran. This study was conducted to identify the strengths and weaknesses of the urban family physician program from the viewpoint of policymakers, administrators, and recipients of services in the city of Shiraz during 2012-2016, using corrective strategies.

This is a qualitative study, and the data were collected through focus group discussions and semi-structured interviews. A total of six focus group discussion sessions and 40 interviews were conducted, and the target sampling was done.

A total of 9 basic concepts and 46 sub-concepts were identified to explain the strengths and weaknesses of the family physician program. The main concepts included: 1- Culture-making and community preparation, 2- Structure and deployment facilities of the program, 3- Manpower training, 4. Service coverage, concept 5. Resources (financial, human, and equipment), 6. Stewardship and monitoring of the program, 7. Insurance system, tariffs, and compensation of services, 8. Clarity of the guidelines and regulations, and 9. Satisfaction with the implementation of the plan.

According to the results of the study, educational planning for public culture-making through the media and newspapers, proportion of the number of people covered by each doctor, aggregation of insurance, and legal requirements for specialists to cooperate effectively are recommended to improve the program.

Peptic ulcer disease (PUD) is a gastrointestinal ulcer caused by gastric acid. Aging, smoking and alcohol, stressful life, and family history are directly related to PUD. Oxidative stress and inflammation are the most important mechanisms involved in PUD. The aim of this study is to evaluate the association of dietary inflammatory index (DII) with the risk of PUD.

In this case-control study, data from 100 newly diagnosed peptic ulcer patients and 150 healthy individuals were analyzed. DII was assessed based on dietary intake data collected through a 174-item validated food frequency questionnaire (FFQ). To calculate DII, 36 nutrients and food components were used after adjusting the energy intake. Adjusted odds ratios (OR) and 95% confidence intervals (CI) regarding the association between DII and PUD risk were estimated by logistic regression.

The mean DII score in patients (0.43±1.88) was significantly higher than the mean DII in healthy individuals (-2.88±2.00) (P=0.005), i.e. patients had received more inflammatory diet. In the crude model of PUD, odds increased significantly in the third and fourth quartiles of DII score compared to the lowest quartile (OR of third quartile vs first quartile: 2.65, 95% CI:1.27-5.52, respectively; and OR of fourth quartile vs first quartile: 2.33, 95% CI:1.12-4.85, respectively; P- trend=0.001). After checking multiple potential confounders, OR in third and fourth quartiles remained high and there was no change in the results.

These findings suggest that more pro-inflammatory diets, indicated by higher DII scores, may increase the risk of PUD. Therefore, anti-inflammatory diet may play a protective role against PUD.

Families of patients with low consciousness have an important role in supporting them and should acquire the necessary capability for patient care.

This study aimed to examine the effect of family-centered interventions on the self-efficacy of the families of patients admitted to the intensive care units.

This research was a randomized clinical trial with a pretest-posttest design conducted in intensive care units of hospitals in Khorram abad City, Iran, in 2019-2020. Seventy family members of patients were selected by convenience sampling and were assigned to the intervention (n=28) and control (n=28) groups by stratified random blocks. The study data were collected through the self-efficacy questionnaire and Hospital Anxiety and Depression Scale. The intervention was carried out using a family-centered model. The collected data were analyzed using the statistical tests of the Chi-square, independent t-test, and paired t-test. Also, the generalized linear model was used to compare changes in self-efficacy scores of the two study groups after adjusting demographic, anxiety, and depression variables.

Data analysis showed that most samples were male (53.8%) with a mean age of 38.15±8.68 years. The results showed a significant difference in the mean scores of self-efficacy, anxiety, and depression between the intervention and control groups (P=0.001). The intervention significantly increased the Mean±SD of caregivers’ self-efficacy (40.14±14.35, P=0.001) in the intervention group. The results showed that the self-efficacy mean score of the intervention group was 36 scores higher than the caregivers’ self-efficacy of the control group (95% CI; 20.6-51.4, P=0.028).

The participation of family members of patients with low consciousness in the care of the patients in the intensive care unit has an effective role in the self-efficacy of caregivers of these patients.

 According to the international diabetes federation, 629 million adults will suffer from diabetes by 2045. Wet cupping therapy is a combination of bleeding and dry cupping and has been used in traditional medicine as a complementary therapy for diabetes. Limonene was shown to have both antioxidant and antidiabetic activity but its potential alongside other treatments has not been thoroughly explored.

 Although wet-cupping therapy is widely used under different conditions, its potential in the treatment of diabetes is not well-examined.

 Male Wistar rats were then injected with alloxan and nicotinamide to induce diabetes. After cupping, the rats’ serum nitric oxide, creatinine, SGPT, SGOT, cholesterol, triglyceride, glucose, GPX, urea, and HDL levels were determined. The glutathione, catalase, glutathione peroxidase, malondialdehyde, and protein level of the serum, renal, and liver were then measured.

 The results showed a significant differences in serum glucose levels among the diabetic rats receiving wet cupping and limonene, in serum glutathione levels in diabetic rats receiving limonene or limonene and wet cupping compared to the diabetic rats, in liver GSH levels in control rats receiving limonene and wet cupping, in the liver GPX activity in control rats receiving limonene, and in liver catalase activity in control rats receiving limonene and wet cupping compared to control group. There was no significant change in serum NO, protein, creatinine, SGPT, SGOT, cholesterol, triglyceride MDA, urea, catalase, HDL, renal GSH, MDA, catalase, liver protein, and MDA Level.

 The findings of the present study suggested that a combination of limonene and wet cupping therapy could be presented as an agent to lower elevated blood glucose levels in diabetic rats. Further clinical studies are required to confirm the findings.

Developmental disorders in children are classified into different domains and early recognition and treatment can significantly affect children’s social and individual functioning. This study aimed to compare growth, development, and related factors in 60-month-old children in urban and suburban kindergartens of Khorramabad, Iran in 2020. This descriptive study was conducted on 100 children aged 60-month-old in urban and marginal kindergartens in Khorramabad city of Iran in 2020. The tools were Ages and Stages Questionnaire (ASQ) and a demographic characteristics information form with census sampling. Children were evaluated for growth indices such as height, weight and head circumference. Data were analyzed by SPSS statistical software (version 21) and Epi-Info software and T-test, Man-Whitney and Kruskal Wallis tests. The type of kindergarten had a significant relationship with the total score of development (P=0.012) and the domains of gross motor (P=0.007) and personal-social (P=0.004). The mean prevalence of the developmental disorder was estimated 8.7% for urban and 16.1% for subarban children. Developmental delay is not related to gender, delivery type, maternal education, child’s history of illness, and economic status of the family (P>0.05) and is related to nutrition and supplement use, the familial marriage of parents, father’s addiction and history of developmental disorder (P<0.05).Implications for Practice: Due to the high importance of timely diagnosis and intervention, it is necessary to diagnose and treat developmental disorders at a younger age. Correct planning of managers in the field of nursing can be effective in timely identification of children's developmental disorders and reducing their prevalence.

Hemodialysis affects the health status and individual roles of patients and affects their quality of life. Therefore, it is important to investigate different educational methods to improve the quality of life of hemodialysis patients. This research was conducted with the aim of comparing the effect of individual and peer education on the quality of life of hemodialysis patients.

In this semi-experimental research, 32 hemodialysis patients from “Shahid Rahimi” and “Shohadaye Ashayer” educational centers of Khorramabad city were selected as available and then randomly divided into two individual and peer groups. After training the peers, 4 peer training sessions were conducted for the peer training group over the course of a month. Individual training was conducted by the researcher for 15 to 20 minutes in 4 sessions during one month. The data were collected before the intervention, immediately after the intervention and one month after the intervention using the questionnaire of demographic characteristics and quality of life index of France and Powers. Data analysis was done using chi-square test, Fisher's exact test and independent t test in Spss software version 23.

There was a significant difference between the average quality of life scores of the 2 groups of patients over time (P<0.001). Also, there was a significant difference between the average of all aspects of the quality of life of the patients in the group of individual education and peer education over time (P<0.001). These changes from the time before the intervention to immediately after the intervention were not significant (P=0.45). But one month after the intervention, there was a significant increase in the average quality of life score of peer education patients compared to individual education patients (P=0.001).

There was a significant difference between the average of all aspects of the quality of life of individual education and peer education patients over time. Therefore, using peer education as a cost-effective and accessible method can be effective in teaching hemodialysis patients.

Considering the importance of hand hygiene in the nurses, this study has aimed to determine the effect of educational interventions based on Theory of Planned Behavior on nurses' intention to perform hand hygiene. In this randomized controlled clinical trial, subjects including 60 nurses were selected by using the convenience sampling method and then were located in the intervention or control groups by the simple random sampling. The intervention group received educational interventions based on the Theory of Planned Behavior through a four-session workshop. Instrument was Theory of Planned Behavior questionnaire with four subscales including attitudes, perceived behavioral control, subjective norms and hand hygiene intention. The questionnaire was filled in the two groups before, immediately after, and one month after intervention. The mean score of attitude, subjective norms, perceived behavioral control, and intention in the baseline of intervention group were 1.96 ± 0.62, 1.87 ± 0.68, 1.84 ± 0.72, and 3.96± 0.64 respectively.  Immediately after the intervention the mean score of these constructs changed to, 2.88 ± 0.68, 2.79 ± 0.79, 3.82 ± 0.69, and 3.78± 0.71 respectively, and the changes were statistically significant (P<0.001). Also education performed in the intervention group increased the scores of attitude, subjective norms, perceived behavioral control and intention in comparison with the control group and changes were significant statistically(P<0.001). The use of educational models could improve the nurses' intention to perform hand hygiene behaviors; therefore, it is necessary to consider this model by modifying the training patterns.

Episiotomy is an incision in the perineal area during the second stage of labor to facilitate delivery. Complications of perineal injuries are one of the most important health issues. Oak pair has long been used experimentally to heal wounds and reduce pain. The present study was performed to investigate the effect of oak pair (Quercus infectoria) cream on pain due to episiotomy in nulliparous women.

This double-blind clinical trial experimental study was performed on 120 nulliparous women in Asali hospital in 2018. Individuals were randomly divided into oak pair cream, placebo, and normal saline groups. Data were collected by demographic and midwifery information questionnaires and numerical pain scales. The creams were used by the participants every 12 hours for 10 days, and the pain intensity was evaluated before the intervention and on days 1, 5, and 10. Data analysis was performed by SPSS using chi-square, Kruskal-Wallis, and one-way analysis of variance (ANOVA) tests.

There was no statistically significant difference in pain intensity scores among the three groups of oak pair, placebo, and normal saline before the intervention (P=0.20). Pain intensity on days 1, 5, and 10 after the intervention showed a significant difference between the three groups in favor of oak cream (P<0.001). The results showed that there was a significant decrease in the mean pain intensity score of the oak pair receiving group over time (P<0.001).

Oak cream might be effective in reducing pain caused by episiotomy due to analgesic properties.

 High-risk behaviors of adolescents and failure to correct their insights and attitudes can have many negative consequences.

 The purpose of this study was to determine the effect of life skills training on adolescents’ tendency to engage in high-risk behaviors.

 The present study was a randomized controlled clinical trial, in which 100 high school students from both sexes were selected via the multistage cluster random sampling method and divided into the intervention (n = 50) and control (n = 50) groups using the block randomization method with a block size of 4. Eight life skills training group discussion sessions of 45 minutes weekly were held for the intervention groups for two months, and a one-hour follow-up session was held 20 days after the end of the eight sessions. The study instruments included a demographic questionnaire and the Iranian adolescents’ risk-taking scale. After confirming the validity and reliability of the instruments and obtaining written informed consent of the participants, they were asked to fill out the questionnaires. Using SPSS 18, the data were analyzed by standard deviations for quantitative variables and percentages for qualitative data, as well as chi-squared test, the independent t-test, and repeated-measures analysis of variance, the results being reported at a significance level of 0.05.

 The results showed that life skills training led to significant decreases in the mean scores of high-risk behaviors, including drug abuse, alcohol consumption, smoking, and violence, at different times in the intervention group in both sexes (P < 0.05), while no significant changes were observed in the control group.

 The results showed that life skills training can reduce adolescents’ tendency to engage in high-risk behaviors.
 

Head lice is one of the most important factors for evaluating the level of personal hygiene in the society, and can cause physical, mental, and social problems in students. The aim of this study was to investigate the epidemiological factors of head lice infestation and the factors affecting it in primary school students in Khorramabad City, Iran, during the years 2018-19.

In this cross-sectional descriptive-analytical study, a total of 3890 primary school students were selected using mixed sampling method, and the data were collected using a questionnaire and direct search. The results were analyzed using independent t, chi-square, and Mann-Whitney tests at a significance level of P < 0.05.

Infection rates were found in 148 students (3.8%), of which, 121 (5.7%) were girls and 27 (1.53%) were boys. Head lice infection had a significant relationship with factors such as gender, place of residence, occupation and education of parents, shared use of personal belongings, use of shared bed, hair length, itchy scalp, common use of mobile and tablet games, infection of other family members, the type of school, and the presence of a school health instructor.

Factors affecting lice infestation are almost entirely related to socioeconomic, cultural, and behavioral issues. Due to the significant relationship between many demographic, socioeconomic, and health factors, by controlling these factors and the necessary training, the prevalence of this infection can be reduced.

Toxoplasmosis is the most important parasitic infection associated with central nervous system. Sufficient knowledge and information about congenital toxoplasmosis and its effective factors is very helpful for health graduates in the prevention, early diagnosis, and treatment of the disease in infants. This study aimed to investigate the knowledge level of senior students related to pregnant women in Lorestan University of Medical Sciences, Khorramabad, Iran, about congenital toxoplasmosis.

This study included 177 students who would deal with pregnant women in their future careers. The studentschr('39') knowledge and information about congenital toxoplasmosis were assessed and measured based on a pre-designed questionnaire. The Mann-Whitney and Chi-square tests were used to compare the obtained data.

The results of this study showed that the studentschr('39') knowledge about congenital toxoplasmosis was not in a desired range (4.72±71.14%). Based on the results, the level of knowledge was significantly lower in nursing and nutrition students (P=0.013), younger age groups (P=0.013), dormitory residents (P=0.002), and undergraduates (P<0.001), compared to other students (P<0.05).

The results of the present study indicated the poor level of information of senior students related to pregnant women about congenital toxoplasmosis. Emphasis is placed on the importance of the disease and its irreparable damage to the fetus, development of plans to increase studentschr('39') awareness of the disease, as well as ways of transmission and prevention.

Nowadays, libraries are core set oriented towards the customer. Therefore, the quality assessment of the libraries must be performed based on the service delivery process to the users. This research was conducted with the aim of measuring the quality levels of library services in Lorestan University of Medical Sciences using the LibQual standard tool.   In this study, a descriptive survey method was used. The statistical population was all active members of the libraries of Lorestan University of Medical Sciences in the second semester of the academic year of 20017-18. The sample size was 323 persons who were selected by simple random sampling method. The data were collected using the standard self-report LibQual questionnaire and analyzed by independent t-test, variance analysis and Tukey post hoc test.   The most satisfaction of the users, from the three components of LibQual respectively, the information control component with a mean of 15.58 ± -0.18, the service effect component with a mean of 14.53 ± 4.22, the library component to The title of a place was 10.80 ± -0.73. There was a significant difference between the level of receiving services and the minimum of maximum expectations (p <0.001).   Libraries' services meet the minimum expectations of users, but they differ between the existing level and the maximum expected level. The dimension of information control had a higher mean than the other dimensions and the library dimension as a mean had a lower mean than the other dimensions. It is also necessary that the relevant authorities have the necessary effort and planning to optimize the conditions in the libraries of Lorestan University of Medical Sciences, especially in the library dimension.

The pathophysiology underlying the progression and development of autoimmune conditions, such as Rheumatoid Arthritis (RA), is a result of dysregulations of the immune system. Research has explored the genetic alterations present in RA; however, limited studies have examined the role of Killer cell Immunoglobulin-like Receptors (KIR) and Human Leukocyte Antigen (HLA) molecules in RA. Therefore, the aim of this study was to examine KIR genes, their HLA ligands, and KIR-HLA compounds in patients with RA.

In this case-control study, a total of 50 patients with RA and 100 healthy individuals were enrolled. DNA samples were evaluated using PCR with sequence specific Primers (PCR-SSP). Odds ratio (OR) with a 95% confidence interval (CI) were reported.

Among the KIR genes examined, KIR2DLA (p= 0.0255, OR= 0.389, 95% CI= 0.210-0.722) and KIR2DS4-full (p< 0.0001, OR= 6.163, 95% CI= 3.174-11.968) were observed to have a statistically significant correlation with disease susceptibility to RA. As an inhibitory gene, KIR2DLA was observed to have a protective effect against RA while KIR2DS4-full as an activating gene, was found to increase risk for RA. No significant associations were found between any of the other KIR genotypes, HLA ligands, or KIR-HLA compounds examined in this study to RA susceptibility.

In this study of RA in the Lur population of Iran, KIR2DS4-full was observed to increase susceptibility to RA, while KIR2DL5A was found to act as a protecting factor based on both the cross Table and regression analyses. Further research should focus on repeating this study in additional populations.

In order to ensure that the quality of health care improves, the observance of medical ethics and patients’ rights is inevitable. The present study was conducted to determine how much dentists practicing in Khorramabad, Iran, in 2020 complied with the Charter of Patients’ Rights.

This was a descriptive-analytical study that was performed on 70 general dentists in Khorramabad from March 2019 to March 2020. The participants were selected by the census sampling method. Data were collected using the Patients’ Rights Questionnaire designed based on ethical codes approved by the American Dental Association (ADA). Data were analyzed using SPSS 20 at a significance level of 0.05.

The mean age was 34.58±7.21 in women and 38.84±9.82 in men. The awareness level of the dentists regarding the Charter of Patients’ Rights was 47±0.12.The highest score was related to explaining and clarifying the charged expenses with 71.4%. The lowest scores were related to providing expert testimony about the illegal practices of a colleague with 22.9% and explaining the treatment method to patients with 25.7%. Work experience had a weak correlation with awareness levels (r=0.2, p=0.095). There was no significant difference between men and women in terms of awareness levels (p=0.139).

Ethical Considerations: 

This article is the result of a research project with the ethical code IR.LUMS.REC.1397.190. Adequate explanations about the objectives of the research were given to the subjects. They were assured that all information collected in this study was confidential.

The awareness level of general dentists who were examined, about the observance of the principles of professional ethics was below average. Therefore, it is necessary for medical universities to pay more attention to aspects of patients’ rights that are less observed by dentists. It is obvious that observing the principles of professional ethics will increasingly gain patients’ trust and as a result, will promote the health level of the society.

Chronic obstructive pulmonary disease (COPD) is a major noncommunicable respiratory disease with diverse pulmonary and external pulmonary clinical manifestations. This disease is one of the leading causes of mortality in the world, and about 1% of the adult population suffers from COPD.

The aim of this study was to assess the effect of Montelukast on the serum level of inflammatory factors in patients with chronic obstructive pulmonary disease (COPD).

In a randomized placebo-controlled trial, 74 patients with COPD with stable conditions were followed for two months after a random assignment to the placebo and montelukast (10 mg/d) groups. All patients continued their treatment protocol irrespective of their group to evaluate the effects of the addition of montelukast on serum levels of common inflammatory factors, such as Tumor Necrosis Factor alpha (TNF-α), C-reactive protein (CRP), and Interleukin 18 (IL-18) in COPD patients. SPSS 18 software was used for data analysis. Results of quantitative data were reported as mean±standard deviation or median (interquartile range) and qualitative data as frequency (percentage). If the data distribution was normal, the paired t-test was used to compare the mean before and after and using an independent t-test to compare the mean changes between the two groups. The Mann-Whitney U test and Wilcoxon signed-rank test were also used if the data were not assumed to be normal. A P < 0.05 was considered as the level of significance.

At baseline, there were no significant differences in laboratory studies between the two groups. After two months of intervention, there was no evidence of decreased TNF-α and CRP in the montelukast group. IL-18 levels were not significantly different at the end of the study between the two groups (P = 0.23), but it had a decreasing trend in the montelukast group (from 20.25 ± 5.98 ng/ml to 16.19 ± 4.17 ng/ml, P < 0.001).

Montelukast complementary therapy in COPD patients only improve the serum IL-18 levels and has not a reducing effect on the level of TNF-α and CRP evidenced by keeping their trend from baseline to the end of the study

low-conscious Patients’ families should be having healthy mental, because of the have a crucial role in the supportive of patient, then this study aimed for determinant of impact the family- center interventions on anxiety and depression of low-conscious patient’s family hospitalized in the intensive care unit (ICU).

This study was a randomize clinical trial with before after design, that conducted in the Shohadaie Ashaier and Shahid Rahimi hospitals’ intensive care units in the Khorramabad city in 2019. 70 people of patients’ family selected by conventional method and allocated intervention and control groups by stratified randomized block design for sexual. Data gathered by the hospital anxiety and depression scale. Intervention conducted based family-centered model for intervention group. Data analyzed by SPSS software and statistical tests such as Chi Squared, independent and dependent T test and ANOVA test.

Data showed, between changes of score average of anxiety and depression in the control and intervention groups were significant deferential statistically(pvalu<0.001).  

  Participation of low-conscious Patients’ families, in the caring of their patients in the ICU could lead to reduce of anxiety and depression of patients’ family members.

 Cesarean section (C-section) not only is associated with health risks for both mother and child, but also is costly. C-section rates are on the rise worldwide. In Iran, it is becoming a major challenge for current population policies.

 The current study aimed to investigate the main factors of the tendency to C-section in Iran.

 In this cross-sectional study 320 pregnant women admitted to health centers in Lorestan province (west of Iran) in 2019 are included. Participants were selected using the multi-stage cluster sampling technique. Data were collected using a demographic form, the Fear of Pain Questionnaire, and the Knowledge and Attitude about Delivery Methods scale. Descriptive statistics and multivariate logistic regression model were employed to analyze the data using the Stata version 14.

 48.44% of participants preferred cesarean delivery. The mean scores of fear of pain in the C-section and vaginal delivery groups were 39.98 ± 8.21 and 36 ± 8.62, respectively, indicating a significant difference (P < 0.001). Level of education of the husband (OR = 2.79), income (OR = 5.9), fear of labor pain (OR = 1.04), history of C-section, and improved attitude toward C-section (P < 0.001) were directly associated with increased tendency to C-section (OR = 0.36); in contrast, female gender of the fetus (OR = 0.36), increased BMI (OR = 0.75), and improved attitude toward vaginal delivery were indirectly associated with women’s tendency to C-section.

 This study showed that while many pregnant women prefer vaginal delivery, the tendency to C-section in Lorestan province is high, which reveals the need to design and implement effective interventions and programs to reduce unnecessary C-section and promote vaginal delivery. Educating families, especially pregnant women, about the advantages and disadvantages of delivery modes, promoting and using new low pain techniques of vaginal delivery, and increasing women’s participation in childbirth preparation programs are effective measures that can reduce the rate of unnecessary C-section.

Regarding to the importance of educational interventions to increase the preventive behaviors of urinary tract infection in children, this study was conducted aimed to investigate the effect of home care education to parents according to the HBM, on recurrence of urinary tract infection in children.

In this quasi-experimental study with a pre and post design, 120 children with UTI who were hospitalized in the pediatric department of Imam Khomeini Hospital in Boroujerd from 23/9/2017 to 23/12/2017 with their parents were selected by simple sampling method and assigned to control and case groups by random block method. The parents of the experimental group received the educational intervention.The data collection tool was questionnaire designed based on health belief model than distributed before and one month after educational intervention. Urin culture was also performed to determine the recurrence. Data were analyzed by SPSS 21 software, multivariate analysis, independent T-test, paired T-test, Chi-square and two-ratio comparison tests.

education reduced the recurrence of UTI in children) P˂0.001). Also, the mean scores of the whole dimensions of the model increased after training in the two groups (P˂0.001). While the difference in mean scores after training in the two groups was significant only in the dimensions of perceived threat (in the case group 3.84±1.21, in the control group 3.03±1.07) (P=0.039), benefits (in the case group 18.78±3.14, in the control group 20.1±2.8) (P=0.019), behavior (in the case group 30.81±3.77, in the control group 30.16±3.47) (P<0.001), and self-efficacy (in the case group 29.53±3.49, in the control group 25.2±3.07)(P<0.001).

According to the effectiveness of home-based caring education based on the HBM to parents of children with UTI,on reducing the recurrence of UTI in children, it is better to before of children discharge with urinary tract infection from the hospital, Providing parenting education about the principles of child care, in order to prevent recurrence of UTI.

Cardiovascular disease is known to be the most important cause of death in Iran. The aim of this study was to determine the frequency of cardiovascular disease and their risk factors in Khorramabad. This epidemiologic cross-sectional study was carried out on 280 patients who were admitted in heart units, coronary care units and heart emergencies of educational hospitals. The sampling method was the census method. Data were obtained from the checklist and included demographic information, different types of cardiovascular disease, and cardiovascular risk factors. The most common cardiovascular disease was unstable angina (36.78), the first symptom of coronary artery disease was chest pain (67.8%), 62.85% were overweight or obese, 40.4%had a history of hypertension, 92.83% did not exercise, 147 (5.52%) were inactive, 72 (25/7%) had a history of smoking, 84(30%) had a family history of heart disease. Fifty-one (18/2%) had a history of narcotic use and the use of opium. According to the findings of this and other similar studies, the frequency of cardiovascular disease differs in terms of country and region, although they are total of high prevalence. Therefore, given the high prevalence of risk factors related to lifestyles including obesity and overweight, physical inactivity, high blood pressure, and smoking, planning education programs, screening and changing lifestyles seems to be necessary.