فهرست مطالب
Iranian Red Crescent Medical Journal
Volume:17 Issue: 7, Jul 2015
- تاریخ انتشار: 1394/04/17
- تعداد عناوین: 14
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Page 1BackgroundUnprecedented growth of fatalities due to traffic accidents in the recent years has raised great concerns and efforts of authorities in order to identify and control the causes of these accidents..ObjectivesIn the present study, the contribution of psychological, social, demographic, environmental and behavioral factors on traffic accidents was studied for young boys in Tehran, emphasizing the importance of psychosocial factors..Patients andMethodsThe design of the present study was quantitative (correlational) in which a sample population including 253 boys from Tehran (Iran) with an age range of 18 to 24 who had been referred to insurance institutions, hospitals, correctional facilities as well as prisons, were selected using stratified cluster sampling during the year 2013.The subjects completed the following questionnaires: demographic, general health, lifestyle, Manchester Driving Behavior Questionnaire (MDBQ), young parenting, and NEO-Five Factor Inventory (NEO-FFI). For data analysis, descriptive statistics, correlation coefficient, and inferential statistics including simultaneous regression, stepwise regression, and structural equations modeling were used..ResultsThe findings indicated that in the psychosocial model of driving behavior (including lapses, mistakes, and intentional violations) and accidents, psychological factors, depression (P < 0.02), personality trait of conscientiousness (P < 0.02), failure schema due to the parenting style of mother (P = 0.001), and perception of police commands (P < 0.002), played an important role in predicting driving behavior. Among social factors, perception of police regulations (P = 0.003), had an important effect on violations and mistakes. Among environmental and behavioral factors, major factors such as driving age (P = 0.001), drug and alcohol use (P = 0.001), having driver’s license (P = 0.013), records of imprisonment or committing a crime (P = 0.012) were also able to predict occurrence of accidents..ConclusionsAs the results of this study show, different factors contribute to different driving behaviors and accidents. The broad scope of these factors links accidents to other social issues and damages..Keywords: Psychosocial Factors, Traffic Accidents, Automobile Driving, Youths
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Page 2BackgroundSome Iranian pilgrims are referred to Iran because of catching a new disease or exacerbation of their disease during the Hajj ceremony. These diseases need prolonged and specialized treatments. Investigation of the reasons led to their return to Iran is useful and effective in policy-making and planning of preventive health services..ObjectivesThis study aimed to investigate the causes of referring Iranian patients to Iran during Hajj in 2010..Patients andMethodsIn this cross-sectional study, all Iranian pilgrim cases in Hajj (2012) who referred to Iran were studied, and data analysis was performed. Demographic data and the causes of return to Iran during and after Hajj rituals were analyzed..ResultsA total of 106 cases were referred Iran during Hajj 2012. Psychiatric problems, with 26.4% allocated the highest rate of return to Iran during Hajj days, and significant difference was observed in the reasons before and after performing Hajj rituals (P = 0.001)..ConclusionsPsychiatric, neurological, gastrointestinal, and respiratory diseases are the most frequent reasons of referring patients to Iran. More accuracy in screening and care of patients are recommended before Hajj in order to prevent references to Iran and its complications..Keywords: Ability, Psychiatry, Neurology, Policy Making, Health
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Page 3BackgroundOne of the limiting factors for early hospital discharge in preterm infants is their inability to feed sufficiently to obtain consistent weight gain. Therefore, feeding difficulty is one of the most significant issues with which a preterm infant is faced..ObjectivesThe purpose of this study was to examine the effect of oral sensory motor stimulation on feeding performance, length of hospital stay, and weight gain in preterm infants at 30 - 32 weeks of gestational age..Patients andMethodsPremature infants (n = 20) were randomly assigned to experimental and control groups. The experimental group received oral sensory motor stimulation of the oral structures (15 minutes / day) for 10 successive days, while these stimulations were not offered to the control group. Days elapsed to achieve oral feeding, length of hospital stay, and weight gain in the two groups were assessed..ResultsTransition to oral feeding was acquired significantly earlier in the infants in the experimental group than in the controls: 13 and 26 days, respectively (P < 0.001). Likewise, the length of hospitalization was significantly shorter in the experimental group than in the control group: 32 days and 38 days, correspondingly (P < 0.05). The two groups showed no significant difference in terms of weight gain in the first, second, third, and fourth weeks of birth: first week: 100 vs. 110; second week: 99 vs. 111; third week: 120 vs. 135; and fourth week: 129 vs. 140..ConclusionsThe present research revealed that the number of days to reach oral feeding in our preterm babies was decreased by oral motor stimulation, which in turn conferred earlier hospital discharge..Keywords: Preterm Infant, Hospital, Weight Gain
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Page 4BackgroundHepcidin is a key regulator of iron absorption in humans. It is mainly affected by hypoxia and iron stores..ObjectivesThe current study aimed to determine the correlation between serum hepcidin and ferritin levels in patients with Thalassemia Major (TM) and Thalassemia Intermedia (TI)..Patients andMethodsThe current cross-sectional study investigated 88 randomly selected patients with Thalassemia, 48 TM and 40 TI, registered at the Thalassemia Clinic of Shiraz University of Medical Sciences, a referral center for Thalassemia in Southern Iran in 2013. All patients with TI were receiving Hydroxyurea (HU) 10 - 15 mg/kg/day for at least 10 years. The serum hepcidin, ferritin levels, hemoglobin (Hb) and nucleated Red Blood Cell (RBC) of the two groups were measured..ResultsNo statistically significant correlation was observed between serum hepcidin and ferritin levels in any of the two groups of patients with TM (rs = 0.02, P = 0.892) or TI (rs = 0.055, P = 0.734). The median Interquartile Range (IQR) for serum hepcidin and ferritin levels were significantly higher in TM compared to TI group, (hepcidin: 87.6 (43.9) vs. 51.8 (23.4), P < 0.001; ferritin: 2208 (3761) vs. 465 (632), P < 0.001)..ConclusionsThere was insignificant correlation between serum hepcidin and ferritin levels in the two groups of patients with TM and TI. It seems that regulation of hepcidin in patients with Thalassemia is more affected by erythropoeitic activity than iron stores. Also, hepcidin levels were significantly higher in patients with TM than TI, possibly due to higher erythropoeitic activity in TI. In TI, it seems that low dose HU increases Hb levels and leads to transfusion-independence, but it is not high enough to suppress bone marrow activity and ineffective erythropoiesis. Consequently, serum hepcidin level decreases..Keywords: Hepcidin, Hydroxyurea, Ferritin, Thalassemia Intermedia, Thalassemia Major
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Page 5IntroductionTraumatic lumbar spondylolisthesis is rare disease and in the literature, different surgical approaches, including anterior, posterior, or combined approaches (posterior and anterior) are used to treat the lesion..Case PresentationWe treated a case of traumatic lumbosacral spondylolisthesis using posterior approach and the patient showed a satisfactory outcome. At the final follow-up, he was completely asymptomatic, and radiographic images revealed normal lumbar alignment and a solid interbody fusion..ConclusionsTraumatic lumbosacral spondylolisthesis can be treated using posterior approach alone to obtain reduction, decompression, and solid fusion..Keywords: Traumatic, Lumbosacral Spondylolisthesis, Anterior Approach, Posterior Approach, Combined Anterior
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Page 6BackgroundPhysical activity and mental health could be affected by osteoporosis and various therapeutic options such as calcitonin may influence Quality Of Life (QOL) of these patients with Low Bone Density (LBD)..ObjectivesThis study aimed to evaluate the effect of nasal calcitonin on QOL in post menopause women with LBD..Patients andMethodsThis clinical trial study was performed on one hundred and fifteen menopause women with LBD less than 1 SD in Bone Mineral Densitometry (BMD) referred to Baqiyatallah Hospital in Tehran, Iran, during 2009 - 2010. They were assigned to receive 200 IU calcitonin nasal spray along with calcium (1000 mg) and vitamin D (400 IU) for 6 months. Quality of life was assessed by Short-Form 36 (SF-36) questionnaire (Persian-validated version)..ResultsThe mean age (± SD) of the participants was 58.75 ± 8.15 years. Intranasal spray of calcitonin increased QOL scores significantly (88.05 ± 15.63 vs. 92.15 ± 13.22, P value = 0.000). Bone mineral density of spine was increased from 0.834 ± 0.11 to 0.12 ± 0.852 and this difference in BMD of lumbar spine was statistically significant (P value: 0.003) but not significant in femur’s BMD (P value = 0.061). In comparison with BMD indexes, The QOL scores especially Mental Health domain changes had only a significant correlation with the changes of total T score in BMD (P = 0.031, Coefficient Correlation = 0.248)..ConclusionsIt seems that nasal spray of calcitonin can effectively improve QOL of women with LBD and QOL changes were not influenced by clinical or para-clinical alteration. Mental health domain must be more considered in further studies as a predicting domain for Health-Related Quality of Life (HR-QOL) changes..Keywords: Osteoporosis, Oteoporosis, Postmenopausal, Quality of Life, Calcitonin, Bone Density
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Page 7BackgroundAcute and chronic inflammations are difficult to control. Using chemical anti-inflammatory medications along with their complications considerably limit their use. According to Traditional Iranian Medicine (TIM), there is an important relation between inflammation and Imtila (food and blood accumulation in the body); food reduction or its more modern equivalent Caloric Restriction (CR) may act against both Imtila and inflammation..ObjectivesThis experimental study aimed to investigate the effect of 30% reduction in daily calorie intake on inflammation in rats..Materials And MethodsA total of 18 male rats (Rattus rattus) weighing 220 to 270 g were obtained. Then, the inflammation was induced by injecting formalin in their paws. Next, the rats were randomized by generating random numbers into two equal groups (9 + 9) putting on either normal diet (controls) or a similar diet with 30% reduction of calorie (cases). Paw volume changes were recorded twice per day by one observer in both groups using a standard plethysmometer for 8 consecutive days. Serum C-reactive protein (CRP), Erythrocyte Sedimentation Rate (ESR), complete blood count (erythrocyte, platelet, and white blood cell) and hemoglobin were compared between the groups..ResultsDecline of both body weight and paw volume was significantly more prominent in the case than in the control rats within the study period (P < 0.001 and < 0.001, respectively). Paw volume decrease was more prominent after day 3. On day 8, serum CRP-positive (1 or 2 +) rats were more frequent in ad libitum fed group comparing with those received CR (33.3% vs. 11.1%). This difference, however, was insignificant (P = 0.58). At the same time, mean ESR was significantly higher in the control rats comparing with that in the case group (29.00 ± 2.89 h vs. 14.00 ± 1.55 h; P = 0.001). Other serum parameters were not significantly different between the two groups at endpoint..ConclusionsRats fed with a 30% calorie-restricted diet in comparison with to ad libitum fed controls for 8 days had significantly more prominent regression of inflammation..Keywords: Caloric Restriction, Inflammation, Animal Models, Iran
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Page 8BackgroundMedical emergency staff complete understanding of the nature of resiliency in burn events is a prerequisite for improving the quality of clinical service delivery in pre-hospital burn events..ObjectivesThe present study aimed to describe resiliency in view of medical emergency staff in burn events..Materials And MethodsThe present qualitative study was performed using a content analysis method. In total, 18 Iranian emergency care personnel participated in the study. A purposeful sampling method was applied until reaching data saturation. Data was collected using semi-structured interviews and field observations. Afterwards, data was analyzed by face content analysis..ResultsBy analyzing 456 primary codes, four main concepts including: 1) scene safety/security, 2) effective clinical decision making, 3) self-efficacy and 4) religious support were extracted through content analysis from experiences of pre-hospital emergency personnel during burn care..ConclusionsDifferent factors affect resiliency improvements in medical emergency staff and consequently the quality of pre-hospital burn care. This study showed that various factors such as scene security/safety, effective decision making, self-efficacy and religious support are effective in the improvement of resiliency and the quality of pre-hospital emergency care..Keywords: Burn Care, Pre, Hospital Emergency Personnel, Resiliency
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Page 9BackgroundPertussis or “whooping cough” is an acute, communicable infection of the respiratory tract caused by the Gram-negative bacterium Bordetella pertussis. It has been recorded in history of medicine that the first pertussis epidemic was reported in 1578 by a French scientist, Guillaume de Baillou, in Paris. Furthermore, the causative agent was first isolated in 1906 by Jules Jean Baptiste Vincent Bordet and his brother-in-law Octave Gengou. However, it seems that earlier reports can be found in history of medicine..ObjectivesThe aim of this study as to analyze the first Report of Epidemic Pertussis by Bahaodowle Razi From the 15th Century Anno Domini.Materials And MethodsWe investigated a copy (Persian lithograph) of the book named “a summary of experiences in medicine”, written by Bahaoddin-bin-Ghasem-Bahaoddin Razi (well known as Bahaodowle Razi) in 1502 to find the earliest existing report of epidemic pertussis in the history..ResultsBahaodowle Razi, a Persian physician from the 15th century Anno Domini (AD), reported two epidemics in Harat and one in Rey (inold Persia) for the first time, one century before Baillou. He named it as Sorfe-ie-Am (meaning public cough). Those occurred during his lifetime. Explaining about his observations and experiences about this epidemic, Bahaodowle Razi elaborated on prognosis, symptoms, etiology and predisposing factors of pertussis..ConclusionsThis document shows that Bahaodowle Razi’s report was the first report of epidemic pertussis in the medical history..Keywords: History of Medicine, Whooping Cough, Persian Medicine
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Page 10BackgroundNocturnal enuresis is the most common pediatric urologic problem in outpatient clinics..ObjectivesTo assess the effect of various monotherapies, and comparing the effects of desmopressin, imipramine, and oxybutynin in children with enuresis, as well as the influence of socioeconomic and cultural factors of their families on the response and relapse rates..Patients andMethodsThe study was a randomized clinical trial conducted on 92 children aged 5 - 14 years, referred to the pediatric clinic of Semnan University Hospital in Semnan, Iran. Children with primary nocturnal enuresis were randomly allocated to three different treatment groups: desmopressin (n = 30), imipramine (n = 31), and oxybutynin (n = 31) all for 6 weeks. The socioeconomic and demographic characteristics of all participants were recorded. The number of wet nights per week was noted at the end of the 6-week-trial, and children were followed up to three months for relapse..ResultsChildren in the oxybutynin group showed a slightly higher response rate (71.0% success) and a lower relapse rate (31.8%), while in the desmopressin group the response and relapse rates were 63.3% and 57.9%, respectively, and in the imipramine group 61.3% and 63.2%, respectively. However, the difference between the 3 groups in terms of response (P = 0.701) and relapse rates (P = 0.095) was not statistically significant..ConclusionsThere is no significant difference between monotherapy with desmopressin, imipramine or oxybutynin in children with enuresis. However, oxybutynin showed a higher response rate and a lower relapse rate compared to other medications. More clinical trials with a larger sample size are needed to clarify these uncertainties..Keywords: Nocturnal Enuresis, Desmopressin, Oxybutynin, Imipramine
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Page 11BackgroundCoronary heart disease (CHD) is an important cause of morbidity and mortality in Pakistan. The temporal trends in the risk factors for myocardial infarction (MI) and the impact of socioeconomic status on these risk factors remain ambiguous..ObjectivesThe objectives of the present analysis were to investigate the potential association between various risk factors and MI in North Punjab, Pakistan, and to assess the status of the control of the risk factors associated with MI in this population..Patients andMethodsThe present study included 515 patients admitted to the coronary care units or equivalent cardiology wards of the participating hospitals between 2011 and 2012 in North Punjab, Pakistan. The analysis was focused on identifying the socioeconomic status, lifestyle, family history of MI, and risk factors (i.e. hypertension, diabetes, smoking, and hyperlipidemia). A structured questionnaire was designed to collect data. The lipid profile was recorded from the investigation chart of every patient. For statistical analysis, the Kruskal Wallis, Mann-Whitney U, Wilcoxon, and chi-square tests were used..ResultsMI was common in the males at the age of 41 - 60 years as compared to the females (P = 0.015). Patients with a positive parental history of CHD experienced MI at a younger age (P = 0.0001) at a body mass index (BMI) ≤ 25 kg/m2. Sedentary lifestyle (70%) and smoking (60%) had a male predominance. Hypertension accounted for nearly 37%, hyperlipidemia 26%, and diabetes 19.4% of the rural and urban subjects (P < 0.01). High-density lipoprotein cholesterol decreased (up to 34 mg/dl), while low-density lipoprotein cholesterol and hypertension increased with age. The mean monthly cost of medicines and physicians’ fees per patient was 2381.132 Pakistani Rupees (24.24 USD)..ConclusionsHigher BMI, positive family history, smoking, hypertension, hyperlipidemia, and diabetes were the strong predictors of MI in North Punjab, Pakistan. Preventive efforts are needed to start early in life and continue throughout the life course..Keywords: Myocardial Infarction, Smoking, Hypertension, Diabetes
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Page 12IntroductionSpontaneous pneumocephalus without any pathological condition is very rare. We described a patient with spontaneous pneumocephalus probably arising from the relatively enlarged air-filling sphenoid sinus..Case PresentationA 51-year-old woman admitted Imam Reza Hospital, Mashhad, Iran with a sudden onset of severe headache and nausea without any neurological deficit. Brain computed tomography (CT) scan was performed to role out any pathology in the brain. Brain CT revealed large ethmoidal and sphenoid sinuses and disseminated intracranial pneumocephalus. A Cerebrospinal Fluid (CSF) examination was performed to rule out meningitis. Further evaluation confirmed a small defect in the sphenoid sinus. She has no recurrent headache or other symptoms after about six-month follow-up..ConclusionsAn extremely rare condition, a spontaneous intracranial pneumocephalus with skull base defect origin could be considered as a possible diagnosis in patients with sudden and severe headache. We can safely conclude that medical treatment and close follow-up is an effective mode of therapy in this patient..Keywords: Pneumocephalus, Sphenoid Sinus, Spontaneous, Traumatic
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Page 13BackgroundAging is an irreversible natural process characterized by a decline in both the physical and mental status of individuals. Because of multiple factors, this process and its consequences vary greatly between individuals. A successful aging (SA) is the target of current health policies and well-being of individuals. Knowing the factors that contribute to SA and its barriers would translate in measurements that increase the quality of life of elderly and reduce health costs..ObjectivesThe aim of this study was to explore barriers and facilitators to Iranian elderly women’s SA..Patients andMethodsA purposive sample of 16 elderly women, aged 61 - 96 years, was recruited for this qualitative content analysis study. Study data were collected during 2012 -.2013 by conducting 16 face-to-face semi-structured in-depth interviews. We continued the data collection until reaching saturation. Study data were analyzed concurrently with data collection, by using the conventional qualitative content analysis approach..ResultsBarriers and facilitators to Iranian elderly women’s SA fell into five main categories, including availability of support systems, state of health, personal capabilities, personality characteristics, and lifestyle..ConclusionsAvailability of support systems, state of health, personal capabilities, personality characteristics, and lifestyle were the main interrelated factors affecting Iranian elderly women’s SA. Accordingly, providing elderly women with strong educational, emotional, financial, cultural, and social supports can help facilitate their SA..Keywords: Aging, Female, Qualitative Research, Iran
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Page 14BackgroundUrbanization and diet change have increased the prevalence of Vitamin D deficiency. Unfortunately, none of the suggested treatments is widely accepted..ObjectivesTherefore, we evaluated the most used and suggested protocol for treating Vitamin D deficiency in Percutaneous coronary intervention (PCI) candidate patients referred to our hospital in a short-term clinical trial..Patients andMethodsAll patients with coronary artery disease, referred to our hospital and candidates for PCI (drug eluted stents) were included. Deficient patients were randomly assigned to treatment (Vitamin D3 pearls of 50,000 IU; one per week for 10 weeks then one pearl every month for maintenance) and non-treatment groups. Vitamin D was measured after nine months..ResultsAfter initial evaluation, 116 cases were found to be deficient, and were divided into two equal groups of 58. No significant difference was found between the normal, treated and non-treated groups regarding age and gender. Thirty-two out of 58 (55.1%) subjects were vitamin D deficient and reached normal levels by taking supplements and seven out of 58 (12%) were deficient and reached normal levels without taking supplements, with the difference being significant (P < 0.001)..ConclusionsThe used protocol is not enough for treating Vitamin D deficiency. Furthermore, the protocol should be revised according to baseline Vitamin D classification..Keywords: Vitamin D, Dietary Supplements, Deficiency