فهرست مطالب shams m

Background and This study aimed to determine predictive factors of a needs assessment and prioritization of interventions to prevent brucellosis using the Precede - Proceed Model in Isfahan rural areas in 2015.
This study was a cross-sectional study (needs assessment by Delphi method) that conducted in 402 people 15 years and older in 20 villages of 44 villages that random selection in the rural Regions of Tiran and Karvan county in of Isfahan Province. The data collected through questionnaires and Self-made checklist based on the Precede-Proceed Model that content and face validity approved by experts and pilot projects. Data collected by the survey techniques agreement using chi-square and t tests analyzed by use of spss18 software.
Findings: This study showed that participants awareness of the possibility of transmission of brucellosis from skin and breathing dust as well as the use of personal protective equipment at the time of contact with animals is not appropriate, increase access ranchers to veterinary services and vaccination of livestock herders in rural areas Help build homes for the animals in the backcountry villages and migration out of the rural areas of the wishes of the population .This study showed that between knowledge, attitude and performance of the participants with their educational level is a significant association (p≤0.05), Also, between enabling factors, reinforcing factors and skill and practice in the prevention of brucellosis and having cattle was significant relationship. (P≤0.05)
Assess the needs before implementing any intervention in the prevention of brucellosis can help to researchers, planners and policy makers to assist in the design and implementation of interventions as well as supplying educational materials situation and priorities of influential Disease Control and Prevention consider put into targeted action that will have more impact cost-benefit.

To present a case of bilateral enlargement of eyelids in 29 year old man with sclromyxedema syndrome.Case Report: A 29- year- old man was referred to labbafinegad clinic with bilateral enlargment of upper and lower eyelids, and foreign body sensation since 9 year ago. Investigating of patients history show renal deasese(hematuria) since 9 year ago. In systemic examination the patients showed hands and feet involvement obviously. At further investhgations sclermyxderma was confirmed. Scleromyxedema is a rare, chronic and persistent idiopathic disorder characterized by a generalized papular eruption due to dermal mucin deposition with an increase in dermal collagen. Uusually associated with a systemic involvement and paraproteinemia. The disease is characterized with mucin deposits in the skin and/or other organs. Its etiology remains unknown affecting both genders equally between 30 and 50 years. The therapeutic options include numerous treatment modalities; however, no standard treatment exists as the rarity of this disease prevents the execution of controlled therapeutic trials.

To evaluate the results of one 60-degree block conjunctival limbal autograft (CLAU) surgery in patients with unilateral total limbal stem cell deficiency (LSCD). Five eyes of 5 patients were included. All patients had a history of chronic total unilateral LSCD due to a chemical injury. Two patients underwent one 60-degree block CLAU with amniotic membrane transplantation, two patients had been complicated by inadvertent trephination of one block of a previous successful two-block CLAU at the time of subsequent corneal transplantation, and the last patient had been complicated by one CLAU segment loss due to loose sutures and premature suture removal. The main outcome of the study was corneal epithelial healing. All patients developed persistent epithelial defect unresponsive to the conservative medical management. To restore epithelial integrity in cases with one-block CLAU, classic two-block CLAU was performed later. In two cases with inadvertent one segment trephination, corneal perforation occurred despite both conservative and surgical management. Tectonic keratoplasty was performed in these two eyes. These grafts developed persistent epithelial defect, which was covered with large sectoral vascularized corneal pannus in one eye and with mucous membrane grafting in the other eye. In the last patient with lost lenticule, cultivated limbal epithelial transplantation was performed to treat the epithelial defect. One-block (60-degree segment) limbal transplantation during conjunctival limbal autograft surgery is not sufficient for anatomical and visual rehabilitation of an eye with total unilateral LSCD.

To describe a novel surgical technique for in vivo limbal stem cell cultivation for reconstruction of corneal epithelium in total limbal stem cell deficiency (LSCD). Patients suffering from chronic total unilateral LSCD due to a chemical injury were sequentially included. One small limbal block (2x1 mm) harvested from contralateral healthy eye sutured over the amniotic membrane (AM) to the superior limbal area of the injured eye. Amniotic membrane extract eye drop (AMEED) at the concentration of 0.1 mg/ml was regularly used until total corneal epithelialization was achieved. All eyes underwent sequential penetrating keratoplasty (PKP) for optical indication and the corneal button was sent for histopathologic examinations and molecular analysis for the detection of limbal stem cell markers. Five eyes of 5 patients with a mean age of 32 years were operated. Mean follow up period was 12 months. Total epithelialization of the corneal surface was achieved in 2 weeks in all eyes. Corneal conjunctivalization and vascularization regressed dramatically after 3 to 4 weeks. Transplanted corneas were clear at the last follow-up examination. No complication developed in donor and recipient eyes. Laboratory examinations showed limbal stem cell markers over the corneal buttons. In vivo cultivation of limbal stem cells over the AM using AMEED is an effective procedure for ocular surface reconstruction in patients with unilateral total LSCD. However, its long term results should be confirmed in studies with a longer follow-up period.

Health literacy is the capacity of an individual to obtain, interpret, and understand basic health information and services and the competence to use such information and services in ways that are health enhancing. The aim of this study was to assess the HIV/AIDS health literacy in Yasuj and its related factors. In this cross-sectional study, a 21-item valid and reliable questionnaire was used. Our sample included 250 individuals aged 15- 49 years that selected by two-stage cluster sampling method and completed the questionnaire. Average of health literacy scores of participants was 10.30 ± 3.36 and only 16.4 percent of them had adequate HIV/AIDS literacy. In modified regression model, there was asignificant association between education (B= 0.40, p<0.001), being governmental staff (B=1.54, p=0.02), and low economic status (B= - 0.52, p=0.02) with HIV/AIDS literacy scores. Most of the individuals in this study had not enough HIV/AIDS literacy level. It seems that lack of access to information and services relevant to the HIV/AIDS; complexity and disproportion of information with audience; and inappropriate form of presenting health messages, cause low health literacy.

The patient rights charter has been developed several years ago. However, in practice, non-observance of the charter items is common in many hospitals and clinics. This study aimed to assess the effect of using a tailored printed media on promoting the observance of the charter in two educational public hospitals in Yasuj, Iran. In this before-after study, the viewpoints of 121 physicians, nurses and midwives about the content and observance of patient rights charter; and the view points of 100 admitted patients about the related personnel practices were explored through two separate questionnaires. Four posters and two pamphlets were developed based on the research findings. Posters were installed in crowded venues of the hospitals; and pamphlets were presented to the personnel and patients. Three months after the intervention, patients viewpoints were assessed again and the proportions of the positive answers were compared with the baseline data. From the perspectives of the personnel, observance of three items of the charter including permission to complaint, confidentiality for patients’ information, and respect to patient privacy, were less functional. Majority of the patients believed that in three items including permission to have a copy of hospital file, taking a bill for given expenses, and admitting the patient respectfully, personnel did not act appropriately. The proportions of positive answers significantly improved three months after the intervention (from 13, 14, and 16 percents to 95, 47, and 86 percents, respectively). Educational print media in which the content has been specified and tailored based on formative research can persuade the target groups to observe the patient rights charter in hospitals.

The effectiveness of the Transtheoretical model for changing nutritional behavior has been questioned by some studies. The purpose of this study was to investigate the relationship between self-efficacy and decisional equilibrium and transfer among the stages of behavior change of a calorie balance intake among obese women inYasuj, Iran. The data of the present descriptive analytical study were baseline data of 447 obese or overweight who were selected using the random cluster method. Based on the Transtheoretical model, individuals pass stages of change, which are precontemplation, contemplation, preparedness, action and maintenance. Two other main constructs which affect the stages of behavior change are self-efficacy and decisional balance. Demographic and anthropometric variables and stages of change, self-efficacy, decisional equilibrium pros and cons related to calorie balance intake were measured using valid and reliable questionnaires. The participants average age was 33.49 years. Neither demographic nor anthropometric variables changes were significant among the stages of behavior change except literacy level before high school (P=.047,OR=.502, %95 CI=.255 ~. 990). A significant change was observed in self-efficacy (F(4.425)= 27.09, P=. 000),decisional equilibrium (F(4.394), P=. 004), and pros (F(4.430)=5.33, P=000), while no significant change was observed among cons (F 4.400)=1.83, P=.123). The findings confirmed the specific model of self-efficacy, decisional equilibrium and pros which predict that the obese women transfer between the five stages of calorie balance intake.

The Internet using has become an important part of individuals, especially youth's daily life activity in recent years. Regarding changes due to using this technology, the question comes to mind is which effects internet using has on life style of its users. The aim of this study was to evaluate student’s life styles and its relationship with using the Internet. The students of Tehran University of Medical Sciences were recruited to this cross-sectional research using multistage sampling. Data were collected using a self-structured questionnaire developed based on a pilot study. Data were analyzed using Fisher's exact test, Man Whitney, and kruskalwalis tests. The results showed that more than half of the participants had unhealthy life style. Only 4.4% of the students had appropriate knowledge on the Internet's effect on their health. Most of the students (70%) believed that using internet had decreased their physical activity. About half of the students (47%) did not believe that smoking would be affected by using the Internet. Regarding the increasing pattern of the Internet using among youth and knowledge insufficiencies among them about the effect of the Internet on health, proper educational programs should be designed and implemented among youth. Moreover, effectiveness Internet-based intervention should be applied to increase knowledge students.

Reasons such as lack of technical and engineering standards in building construction, inefficient communication networks, lack of urban facilities and equipment, urban eroded tissues and marginal urban settlements, as well as, non-standards in developing countries are more than the other tissues exposed to earthquake. Reducing the vulnerability of the city against earthquake is one of the main objectives of physical planning and urban planning. This paper has paid attention to Feyzabad district of Kermanshah city for Crisis Management with emphasis on earthquake as vulnerability evaluation indices such as type of material, oldness buildings, number of floors, user type, occupation level, quality of buildings, population density, street width and the area. Have been studied first, each indicator was individually and based on expert opinions weighed, and then these layers were weighed in the Idrisi software based on AHP method in binary comparison matrices. Finally, the weight of each indicator was defined and combined to obtain the final map of vulnerability layers. Output maps of vulnerability demonstrate that totally, 70.61% Feyzabad district are vulnerable based on indicators.

Planktonic algal samples were taken from Zayandeh Rood Dam lake of four stations, and from surface, 0.5, 3 m depths. Triplicate samples were gatherd by Nansen sampler in each sampling occasions. Additional samples were taken from the surface with plankton net. Samples fixed with 4% formaldehyde and were centrifugated to final volume 300 ml. In this study 112 species belonging to 53 genera were identified. Cyclotella meneghiniana kutz, a centric diatom, was dominant species in the period of study. Physico- chemical parameters such as temperature, salinity, pH, EC, DO, BOD, COD, NO3, PO4, SO4 were also determined. The present study revealed that Zayandeh Rood Dam lake is an oligo- mesotrophic water, and some phytoplanktons can be use as indicators for evaluating of water quality.

There are many interventions for encouraging the women to do breast self-examination. In this study, we aimed to review the studies on the effectiveness of health education interventions to improve women behaviors related to breast self- examination. In this study, efforts have made to search for related materials in Pubmed and ISI Web of Science. It was attempted then to retrieve full-text copies of all relevant findings, and to read, include and classify in review the publications that focused on impact assessment of any health education intervention to facilitate earlier diagnosis of breast cancer. Most of the studies were done in the form of training methods and most of the trainers were the health personnel but in some cases peer educators and family members of the patients with breast cancers had been used as trainers, too. The trained groups were different from aspect of age, race and ethnicity, literacy level and job and in some studies we found that first- level relatives of patients with breast cancer had considered as an important group which needed training. Educational interventions for improving the knowledge, attitudes and behaviors of the women act as an important factor in exploration and early treatment of breast cancers. The educational interventions done by nurses and other health professionals provide more effective educational interventions than physicians and attention to suitable place for introducing this kind of educations such as health care facilities and classes in worksite tend to more successes.

Choosing the effective disinfectants and using the standard methods of sterilization in hospitals, can be useful in decreasing nosocomial infections. The aims of this study were the evaluation of efficacy of disinfectants being used in surgical rooms, ICU, CCU, burn wards and delivery rooms of Hamedan hospitals and also determination of bacterial contamination. Methods and Materials: In this study 400 samples were collected from different parts of operation rooms, ICU, CCU and delivery rooms of four hospitals (Mobasher Kashani, Imam Khomainy, Ekbatan and Fatemieh) in 2006. The samples were cultured on blood agar, then the microbial agents were identified by differential and biochemical tests. Disinfectants that were used were as follow: Cidex (Glutaraldeyde), Sodium hypochlorite, Kereoeline 2.5%, Hygiene1%, Betadine, Alcohol 70%, Savlone 3.2%, Chlorohexidine 1%. The efficacy of disinfectants was evaluated on 60 Staphylococcus epidermidis and 60 Pseudomonas aeroginosa through disk diffusion method. Data were gathered through a questionnaire and analysed using T-test and SPSS software. Contamination tests in the four hospital were positive in 44.5% of cultures (178 cultures). The highest frequency of contamination was in Mobasher hospital with 38.2% and the less frequency was in Fatemieh hospital with 13.5%. From 400 samples, 52.2% of isolates were gram-positive bacteria and 47.7% were gram-negative bacteria. The most important bacteria isolated were as follow: E.coli, Staphylococcus epidemidis, Micrococci, Bacillus subtili and Pseudomonas aeroginosa. The most effective disinfectants on 60 Staphylococcus epidemidis were as follow: Cidex, Sodium Hypochlorite and Kereoeline and the least effective disinfectants and antiseptics was Alcohol 70%. The most effective disinfectants on 60 Pseudomonas aeroginosa were as follow: Cidex and Kereoeline and the least effective disinfectants and antiseptics were Alcohol 70% and Savlone. results showed that kereoline and cidex were among the most effective disinfectants, and there is not a significant difference between their effects on staphylococcus epidermidis (P=0.469) and on pseudomonas aeroginosa (P=0.053). The efficacy of other disinfectants on two mentioned bacteria were different and significant differences were found.

Obesity is associated with both higher bone mineral density (BMD) and plasma leptin con-centration. Inconsistent data are available about the relationship of leptin concentration and BMD, and the aim of this study was to explore the relationship of plasma leptin concentration with BMD as well as bone-related markers in healthy postmenopausal Iranian women. Two-hundred and ninety-six postmenopausal women from a popu-lation-based study on prevalence of osteoporosis in Shiraz participated in this study. The BMD was determined at the lumbar spine (L1-L4) and neck of femur by dual-energy X-ray absorpti-ometry. Blood samples were taken in the fasting state for plasma leptin, serum parathyroid hor-mone, creatinin, calcium, albumin, phosphorus and alkaline phosphatase evaluations. The mean age of the participants was 60.75±7.46 years and the mean body mass index (BMI) was 27.51±5.3 kg/m2. Mean leptin concen-tration was 18.12±9.08 ng/ml. One-hundred and forty-two (48%) individuals were osteoporotic, with mean plasma leptin concentration being significantly lower in these individuals (P<0.0001). BMDs at both the lumbar spine (r=0.25; P<0.0001) and the neck of femur (r=0.29; P<0.0001) had significant positive correlation with plasma leptin. The association between BMD and plasma leptin concentration was no longer significant when adjusted for BMI. There was no correlation between plasma leptin con-centration and bone-related markers. This cross-sectional study suggests that the relationship of plasma leptin concentra-tion with BMD is mediated through obesity and plasma leptin is dependently associated with BMD.

The causes and incidence of facial fractures are various and continue to change studies form Nigeria, Libya, Europe, and the United States showed that traffic accidents were the most frequent cause of facial fractures. Now, assaults are the most common cause of facial Both the incidence and etiology of maxillofacial fractures vary from one country to another. Reports on the causes and incidence of maxillofacial fractures in Middle Eastetn countries are few. No reports on the incidence and etiology of maxillofacial injuries in Iran have been punlished. Our study evaluated 211 maleand 26 female patients 3 to 73 years of age. The age, sex, cause of injury, site of injury. type of injure, treatment modalities and complications were evaluated. There were 173 mandibular, 33 maxillary. 32 zygomatic, 57 zygomatico - orbital, and 5 cranial, 5 nasal and 4 frontal injuries. Regarding distribution of mandibular fractures the most 32%, were seen in the condylar region. 29.3% in the symphyseal - parasymphyseal region 20% in the angle region. 12.5% in the body 3.1 in the ramus, 1.9% in the dentoalveolar, and 1.2% in the coronoid region. The distrbution of maxillary fractures was: LeFort II in 18, LeFort I in 8, LeFort III in 4, and alveolar in 3, Car accidents caused 73 (30.8%), motorcycle accidents 55 (23.2%), falls 48 (20.3%) alercations 23 (9.7%), sports l5 (96.3%), and warfare 23 (9.7%) of the mascullofacial injuries. In this study road accidents (cars and motorcycles) were the most common cause of these fractures and cornprised 54% of the etiology ofthe fractures.

Over a period of one year, 24 soil samples collected from different parts of Abyaneh region in sphahan were analyzed for the presence of aflatoxin producing strains of Aspergillus flavus and Aparasiticus. Twenty-one isolates were identified based on the macroscopic and microscopic criteria. These isolates were present in 50% of the samples and their ability to produce aflaloxin was examined in glucose-yeast extract (OY) agar medium by ultra-violet (UV) photography. In the UV photographs, aflatoxin-producing mould colonies (8 isolates) were appeared in gray or black color, whereas aflatoxin-nonproducing mould colonies (13 isolates) were appeared in white color. All the UV positive or negative isolates were confirmed by thin-layer chromatographic (TLC) analysis of chloroform extracts obtained from OY agar and yeast extract-sucrose (YES) broth media. Among 8 aflatoxin-positive isolates, 3 isolates produced both aflatoxins B1 and B2, whereas 5 isolates produced only aflatoxin B1. The concentration of aflatoxin HI in the isolates producing aflatoxin ranged from 0.45 to 2.~1,ugJg OY agar medium. The results showed that the UV photography in OY agar medium could be used as a rapid and reliable screening test for identification of the isolates of A flavus and A parasiticus strains that produce aflatoxin.

Abstract: Aflatoxin contamination of food and feedstuffs is a serious economic and health hazard. Over a period of two years, 35 samples of raw pistachio nuts collected from different parts of Iran were analysed for the presence of aflatoxigenic strains of the Aspergillus flavus group. Eighty-five isolates of A.flavus and A.parasiticuswere identified based on specific yello-orange pigment production in the reverse of the colonies on Aspergillus flavus and parasiticus agar (AFPA) medium and microscopic criteria. These isolates were present in 65.71% of the samples and their aflatoxin-producting ability was examined. At first, 12 out ot the 15 aflatoxin-producing isolates were selected based on bright blue fluorescence colour on aflatoxin-producing ability (APA) medium. Later, all of the isolates were identifid after culturing on sucrose-low salts (SLS) medium. Furthermore, aflatoxin production on APA and SLS media was confirmed when the mycelia and media were extracte and analysed fo aflatoxins on TLC plates. A.flavus strions produced mainly aflatoxin B1 with concentrations rangiong from 0.21 to 1.49 µg/g of APA medium, where as A.parasiticus strain produced all four aflatoxins (B1, B2, G1 and G2) with 3.71 µg aflatoxin B1/g of the medium. Isolates other than A.flavus and A.parasiticus grown on this specific culture medium failed to produce a characteristic fluorescence under UV light. Evidences from this study indicate that fluorescent production on APA medium is a reliable screening test for distinguishing potential aflatoxin-producing strains of A.parasiticus from nontoxigenic strains.