Daneshvar Medicine: Basic and Clinical Research Journal
Year:2005 | Volume:13 | Issue:59|Papers Count:9

This is an Analytical study (Quasi-experimental), that was conducted to measure the effect of home visiting program on the mothers' practice in developmental process in children at Islamshahr area in 2000. First, four health centers randomly were selected, then among them 60 preschool children and their mothers, were selected through no accidental sampling and divided randomly as the case and control groups. All demographic variables (child's sex, parents' literacy and etc) from two groups were matched and chi_square test and Independent t-test, didn't show significant difference between them (p>0.05). Tools for data gathering were demographic questionnaire, Interview guide for assessment of mother's practice, checklists for developmental assessment and etc. In pretest phase, these tools, have measured by home visit in three sittings. Then, home visiting program for mothers in case group in 4-6 sittings for two months was done. That was about developmental process in preschool children and role of mothers' in promoting of development. Every sitting was about 45 minutes. Then for one month there wasn't any education for case group. Again, tools were measured in three sittings by home visit and results were compared. Findings showed a significant difference after interaction between case and control groups and in the case group before and after the conduction of the program (p<0.0001). All the demographic variables of child and family hadn't any correlation with mothers' practice and child development (p>0.05). According to the results, it is suggested that home visiting program applied as a basic and essential approach to increasing practice of mothers' about developmental process.      

Introduction: Life expectancy is closed to sixty-five yeas in the world. This rate is higher in developed countries but lower in developing countries. In Iran life expectancy is higher than the mean of that in the world, this means that the elderly is increasing. About 13% to 18% of women and 3% to 6% of men in the age of fifty and more are suffering from osteoporosis. It is believed that by involving of public can understand needs of community health to plan for meeting them. In attention to important role of health volunteers in education and preventing of disease including osteoporosis, this study was done to survey of knowledge, attitude and practice of those and to measure effect of health education program based on health promotion in the filed of osteoporosis. Materials & methods: This study is a quasi-experimental in which seventy health volunteers in Semnan city are involved and selected randomly. The tool of collecting data demographic characterizes knowledge, attitude and practice. The questionnaire was full out in two time interval 3 months. One time before teaching based on health promotion model and another after teaching, and data were analyzed by SPSS. Results: The data showed that in the first stage, sixty percent of cases were between 30-40 years old. 45% of them were diploma, Comparison of the results before and after educational intervention showed that health volunteers knowledge, attitude and practice before intervention was insufficient and joined with false beliefs and ideas as well as incorrect imagination, but the project based on health promotion model has rectified and deepened the information. Discussion: By using of participation-based education especially in health volunteers, it is possible to involve them more with educational subject to prevent from disease such as osteoporosis.      

Introduction: Breast cancer is one of the most prevalent diseases causing the mortality of middle - aged women in developed and developing countries. According to the latest statistics published by the Iranian center on Diseases control in 1995, after skin cancer, Breast cancer is the most prevalent cancer among women in Iran. The percentages of women affected by skin and breast cancers are 15.68% and 14.7% respectively. However, it is noticeable that malignant tumor is the most important and serious type of breast cancer in Iran. Since most of the sufferings from breast cancer want to have more information about the probable consequences of the disease and the duration of their survival. This study was taken up to find out relevant answers to the mentioned questions. Therefore, it is necessity to determine the factors influencing survival time as well as awareness about the period of survival. Methodology: In present study Kaplan-Meier life tables were prepared based of which survival probability for different months after treatment until 5 years assessed. Meanwhile, homogeneity of survival time distribution in different population under study were examined through Wilcoxon and logrank test. The results revealed no homogeneity of survival time distribution among patients with respect to the first location of tumor emergence, different treatment methods and age groups. In addition, the most appropriate hazard model was developed by of Weibull regression method. Results: The model showed that the survival time of patients treated through surgery method was 1.29 times more than those treated through radiotherapy method. Over survival time of patients treated through simple mastectomy, modified radical mastectomy and extended radical mastectomy were 1.48, 1.46 and 1.34 times more than that of non-surgery method respectively. The study also showed that with the increase in the age of patients, the survival time after treatment was reduced.      

Introduction: This semi-experimental study with before - after format of intervention was conducted to evaluate the effect of performing directional program on documentation quality of nursing notes in CCU of Mostafa Khomaini Hospital in 1381 (2003). Material and Method: The subjects consisted of all CCU nurses. Also, the patient's records were randomly selected without replacement. Data gathering tools included a questionnaire for determining nurses' attitudes toward their notes and a checklist for documentation quality of these notes. Before intervention, documentation quality and nurse's attitudes were assessed by evaluating 52 notes and the questionnaires. Directional program consisted of 5 stages: 1) Holding 2-3 individual sessions for providing or enhancing positive attitudes toward nursing notes, ways of correct documentation, and discussing about functional and case methods; 2) Providing nurses with educational pamphlets about documentation and common conditions in CCU, a checklist regarding documentation, CCU cardex, and books such as "pharmacological guides... in nursing station", 3) Changing task division from functional to case method; 4) Practicing correct documentation with nurses; and 5) performing directional program by personnel and changing the responsibility of controlling and checking nursing notes from head nurse to charge nurses of each shift. 1-5-2 months after the program, data regarding documentation quality and nurses' attitudes were gathered again. Results: Findings showed no significant difference between nurses' attitudes before and after intervention with McNimar test (p<0.62). Thus, the first hypothesis of the study, namely, "the effect of directional program on improving attitudes toward nursing notes" was not verified. In addition, there was a significant difference between documentation quality with Qui-Square test (p<0.01) and between mean scores of documentation with paired T-test before and after intervention. Therefore, the second hypothesis of the study, i.e., "The effect of directional program on changing documentation quality of nursing notes" was verified. There was also a significant relation between nurses' attitudes and documentation quality after intervention. A significant was also found relation between sex, nursing experience, and documentation quality. The effectiveness of the program was 81.75. Conclusion: It can be concluded that nursing managers can use appropriate directional program to make desired changes in clinical practice.      

Background & purpose: With respect to extended distribution of scorpions in Iran suitable climate, environmental and geographical condition of Kashan distinct for many dangerous species of these creatures (especially Butidae species) as well as their activities along many months and high spread scorpion bite in Kashan region, epidemiological indices of patients referred to emergency and medical centers during 1991-2002 were studied. Materials & methods: In This descriptive study medical chart of all patients with scorpion bite during this period reviewed and our needed data recorded in information sheets and after codification were analyzed. Results: Among 367 subjects with a mean age of 23/1±15/1 years old and sex ratio of 67% male and 33% female, the most relative frequency of scorpion bite were included the small children under 9 years old (36/5%), lower limbs (64/3%) , rural areas (58/3%) , July and August months (respectively 27/5 and 21/5%) and, black scorpion bite (34/9%). Most of the patients were suffered from inflammation and pain, In 7 case that scorpion bite led to death(1/9%), 4 dead victims were female, 3 people were bitten by yellow species ,3 by black and1 case unknown. Conclusion: Due to dangerous complication of scorpion bite, it is suggested that members of families especially those families residing in villages be instructed about taking care children, observing immunity measures and using suitable clothes and shoes at night.      

Introduction: Nasolacrimal duct obstruction (N.L.D.O) is a bothersome and troublesome ocular disorder in ophthalmology. Considering the etiology, researchers have divided the disorder in two types: primary N.L.D.O (PANDO) and secondary N.L.D.O obstruction, the subject that has not been considered significant and noticeable in many studies. Material & Methods: We have selected 50 were patients randomly selected from 6750 patients, referred to Shaheed Mustafa Khomeini Hospital due to these general ophthalmic problems within recent 2-5 years with unilateral or bilateral N.L.D obstruction as a case group. 50 persons without N.L.D obstruction from patients' families were selected based on age sex and residency as a control group. After completion of consent letters, gathering questionnaire forms and ocular and nasal clinical examination we compared the two groups for nasal obstructive disorder such as: septal deviation, trubinate hypertrophy, sinusitis, polyps, tumors, allergic conditions and other deformities. Results: In comparison with control group septal deviation and the side of deviation were the most important factors in N.L.D obstruction (p=0.00), and the second important factor was turbinate hypertrophy (p=0.01). Chronic sinusitis plays an important role especially in unilateral forms of N.L.D obstruction. It is necessary to evaluate other etiological factors in a larger sample to confirm their effects. Finally, 84 percent of the cases had at least one of the above - mentioned pathologies in nose contrary to 40 percent in control group (p<0.05) and 60 percent of cases had more than one obstruction pathology as compared with 20 percent in control group (p <0.05). Conclusion: Septal deviation, trubinate hypertrophy, tumor and other obstructive diseases in nasal cavity have important effect on nasolacrimal duct obstruction so, before any surgery for N.L.D obstruction E.N.T consultation is recommended.      

Introduction: Chryseobacteria is a generation of aerobic gram-negative rods which can cause infection in neonates and immunocompromised individuals. Material & Methods: This report describes the first isolation of Chryseobacterium meningosepticum from a 15-month-old infant with sepsis manifestation in Doctor Sheik hospital, in Mashhad. Results: Chryseobacterium meningosepticum was identified in blood culture of the male neonate with Griscelli syndrome (partial albinism with variable immunodeficiency) and a history of recurrent and chronic infectious diseases. Conclusion: The present study is of great importance since this is the first reported case of Chryseobacterium isolation in Mashhad.      

Introduction: Diabetes mellitus is a group of metabolism disease that is often asymptomatic in its early stages and the chronic hyperglycemia is associated with long-term dysfunction, damage and failure of various organs. Early diagnosis of diabetes not only prevents progressing of disease and complications but also is cost-effective. This study was conducted to Survey the risk factors turn up of diabetes mellitus in women with previous gestational diabetes mellitus (GDM). Material &Methods: In a prospective study, after offering the prenatal cares and recording the complications during pregnancy delivery and postpartum at least 6-8 wks after delivery, for all women with GDM screening was done with 75gr oral glucose and based on the American diabetes association (ADA) criteria three groups (normal, Impaired and overt diabetes) were diagnosed. Statistical analysis was performed with SPSS version 9.0 and Hest, chi-square and Fisher exact test, One-way analysis of variance, Q-Q plot for normality and Logistic regression were used. Results: From 63 pregnant women with previous GDM, 7 women (11%) had IGT or impaired fasting glucose (IFG) and 8 women (13%) had overt diabetes. In women with overt diabetes the rate of glycosuria (Odds ratio=8.6, CI=1.6-45.5, p<0.05) and age~30 (Odds ratio=14, CI=1.6-123.8, p<0.01) as risk factors of gestational diabetes mellitus, elevated FBS in GTT (Odds ratio=14, CI=1.6-123.8, p<0.01), diagnosis of GDM in early pregnancy (Odds ratio=1.3, CI=0.99-2, p<0.05), insulin therapy (Odds ratio=0.04, CI=0.01-0.2, p<0.001) also the rate of still-birth (Odds ratio=2.3, CI=0.99-5.5, P<0.001), Gestational hypertension (Odds ratio=11.3, CI=1.7-75.2, p<0.05), hydramnios (Odds ratio=18.8, CI=1.43-245.9, p<0.01), respiratory distress syndrome (RDS) (Odds ratio=70.5, CI=4.9-1017.2, p<0.01), neonatal hypoglycemia (Odds ratio=10, CI=1.4-72.7, p<0.05), had statistical difference with normal group. Conclusion: The finding indicated that the rate of odds in turn up of overt diabetes in GDM women ages 30, glycosuria, the high rate of complications, elevated FBS in GTT, Diagnosis of GDM in early pregnancy and need to insulin therapy during pregnancy was high, also Logistic model showed that insulin therapy during pregnancy is the most important factor in turn up of overt diabetes after delivery.      

Introduction: Although there are numerous evidences which show that consumption of iron, as supplementary has element remarkable positive effects on iron status in pregnant women at their delivery, and later hemoglobin with increased risk of small embryo gestational age, still birth, pregnancy induced hypertension, intrauterine restriction, low birth weight, preterm birth, and prenatal death. In these cases, it seems that normal blood volume has been decreased in pregnancy. Material & Methods: 193 pregnant women with hemoglobin concentration higher than 13.2 grids in 13th and 18th weeks of pregnancy participated in a randomized double blind placebo-controlled trial. One hundred and twenty two women were given one ferrous sulfate pill containing 50 mg iron, daily from 20th week of pregnancy up to the end of it and 71 pregnant women were given one placebo daily during the same period. In order to control the procedure for hemoglobin changes, all women took blood tests in the 24th - 28th and 32nd - 36th weeks of pregnancy, If their hemoglobin concentration decreased less than 10.5gr/dl in the first trimester and less than 11 gr/dl in the third trimester, they were excluded from the study for the iron treatment. Results: The results of this study revealed that routine consumption of iron supplementation by pregnant women from second half of pregnancy with hemoglobin concentration higher than 13.2 gr/dl in 13th - 18 weeks of pregnancy in comparison with pregnant women who have not received iron supplementation significantly increases low birth weight frequency (less than 2.5kg). But, there was no significant difference between two groups in duration of pregnancy, pre-term delivery, and type of delivery. Conclusion: In sum, it seems that consumption of iron supplementation by pregnant women whose hemoglobin concentration is higher than 13/2gr/dl in the second trimester may slow down the reduction of hemoglobin, hematocrite, and ferritin levels during pregnancy, which exposes them to the increased risk of low birth weight because of lack of suitable blood hemodilusion and ultimately damages utero-placental circulation.