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In order to determine the relationship between breast feeding and growth pattern, the information about anthropometric measurement and feeding pattern in first 4-6 months of life and after that of 324 hospitalized children were recorded and analyzed results are as follow: 67.3% were exclusively breast-fed, 61.3% were breast-fed accompanied with non-maternal milk (Cow milk, formula, pasteurized cow milk) and 11.4% were fed with non-maternal milk only. 44.8% of the total patients had weight for the age under 5th percentile, 53.7% had height for the under 5th percentile and 26.9% had head circumference (HC) for age under 5th percentile of NCHS standard. 77.8% of infants under 6 months of age who had weight for age under 5th percentile never have been fed with breast milk. In the other hand 72.2% of patients with weight for age between 5-100th percentile fed exclusively with breast milk in first 4-6 months of life (P<0.03). 63.2% of infants aged 6-12 months with weight for age under 5th percentile have never been fed with breast milk in first 4-6 months or did not commence supplementary food on time. This study suggest that exclusively breast-feeding in first 4-6 months of life and continuation of breast milk beside supplementary food on proper time can provide better growth potential relative to other options.

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Intestinal parasites have worldwide prevalence and is considered to be as one of the most important hygienic problems in the world. As a whole, we can say there is no where in the world without parasites infestations. For the assessment of parasitic infestations of children under 2 years old in urban areas of Semnan, sample of stools for 3 consecutive days of 359 children under 2 years old, whom were accompanied by their mothers to the health center, were obtained. Samples were recognized by Formalin/ether and direct methods and thionin staining. From 359 children below 2 years old that their stools were examined, 14.2% of them had Protozoa infestation and Giardia Lamblia by 10% was the most common parasite. In these children, infestation by intestinal helminths was not seen and infestation by pathogen parasites was seen in 10.3%. There was significant association between the age and infestation by intestinal parasites (P=0.0000). There was not any significant association between the sexual, areas condition (Tropical/cold) by intestinal parasites. The most common parasite was Giardia. Therefore, educating mothers the principles of hygiene, can prevent infestation to parasites and the potential complications.

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The word human population has been terrified nay AIDS. The barbers are persons that work with sharp tools. If their instruments become infected, they can transmit the infection to others. Therefore, the purpose of this study is to determine the barber’s knowledge, attitude and performance about AIDS prevention. This project is a descriptive study on 150 selected barbers. The methodology of research was a set up questionnaires, that have been completed by the barbers. The results showed that, their knowledge, performance about the AIDS are moderate (50%, 48.43%) and their attitude are weak. Performance among men and women is significant (P?0.02) in addition correlation between knowledge and attitude, attitude and performance are significant, according to the duration of working as barber (P?0.01). In general knowledge, attitude and performance among barbers are weak, therefore it is suggested that health and hygienic official teach the barbers how to behave in this regard.

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Drug addicts, especially those practicing injection, are regarded as a major high-risk group for HIV infection. This study was performed to determine the burden of infection in 1061 drug addicts residing in the rehabilitational camp of Shiraz. In 1998, a survey in 1061 randomly selected drug abuse residing in the rehabilitational camp of Shiraz were performed in which demographic and other required data were collected using a questionnaire and samples from each subject were tested for anti-HIV by ELISA-II and then western blot. Overall, 0.76% of subjects were positive for anti-HIV detected by ELISA-II, 1.2% among intravenous and 0.33% among non-intravenous drug abusers, which, being several hundred times more than the prevalence in the general population. Points to the fact that drug addicts must be regarded very high-risk irrespective of their principle method of drug use. The high prevalence among non-intravenous addicts also may be indicative of the possibility that they have practiced high-risk injection sometimes during the period of addiction or imprisonment. Due to the low number of positive cases, no relation could be established between the age, duration and method of drug abuse, history of imprisonment, job, tattooing, marital status and HIV infection. Authors recommend widespread education of the community and drug abuser population in order to reduce the prevalence and spread of infection in addicts an the society, active case-finding among drug abusers, particularly before their referral to rehabilitational centers and developing control measures along with educational program to prevent the residents of these centers from access to drugs and practice of high-risk methods such as needle-sharing.

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Recent publications have questioned the efficacy of massage. It is acknowledged that critical care environment are stressful for patients in term of invasive medical, and nursing procedures. Continuous brighting and excessive noise prohibits the potential relaxation and sleep. In this article, which is a research study, the physiologic response during and following a five minutes administration of back massage are described. This study is a semi-experimental research in which a 5 minutes back massage was offered to 25 patients as stress reduction intervention. Physiological data (Heart rate, mean arterial blood pressure, respiration and peripheral oxygen saturation) were obtained from the patient bedside monitoring system. Results indicated there was significant effect from the intervention on peripheral oxygen saturation (P<0.002). However, a significant decrease in heart rate (P<0.001), blood pressure (P<0.001) and respiration rate (P<0.001) was observed during the back massage intervention. Results indicated back massage had the potential effect of increasing relaxation as evidenced by physiological change during the intervention administration to critically ill patient in intensive care unit massage was found to be a useful therapy to enhance relaxation and sleep in critically ill patient.

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All the different kind of Mycobacterium species except Tuberculosis Leprae and Bovis are considered as environmental Mycobacterium, which usually can be isolated from sand, water and dusts. In addition to the role of their pathogenesis, they can stimulate the immune systems. The immune mechanisms following Mycobacterium environmental contamination can be either protect or destroy the immune system when facing the disease related to the Mycobacterium. The Golestan province has got 2 regions from the point of view of TB epidemy, it is higher in the east. The aim of this project is determine the prevalency of various types and strains of environmental Mycobacterium in the east and west of the region. The samples were collected from both regions from the wet sand, and muddes covered with grass and following their preparation they were cultured on the Lowen Stein Jenson. The total of samples were 220 from these 120 samples were from the region with epidemy of TB out of these we had 25 samples with positive culture (20.8%) and 47 type of mycobacterium were isolated, the most common forms of them were Mycobacterium Fortuitum (34%), Mycobacterium Flavesens (21.2%), Mycobacterium Chelonae (12.8%). From 100 samples taken from the region with low epidemy of TB 66 samples were with positive culture (66%) which 114 strains of Mycobacterium were diagnosed. The most common forms of these microorganisms were Mycobacterium Flavesens (20.1%), Mycobacterium Chelonae (18.4%) and Mycobacterium (16.6%). In conclusion in all the Golestan province without taking notice the TB epidemy form 220 samples 91% were positive culture (41.2%) which 161 different strains were diagnosed out of these the most common were Mycobacterium Fortuitum (21.8%), Mycobacterium Flavesens (20.5%) and Mycobacterium Chelonae (16.8%). The epidemy and variousity of environmental Mycobacterium in the region with low epidemy were much higher than the region with high epidemy and in regard to that these differences are due to the bioenvironmental factors. So therefore this can indicate that the possibility of higher contact between the immune systems and the environmental Mycobacterium. These Mycobacteriums can act as Booster of BCG vaccine which can continuously stimulate the immune systems and this can help the body’s proper responses when facing with the TB Mycobacterium.

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Background and objective: Nosocomial infections are the important problems in health care centers in the world. Incidence rate in different countries is very variable and has been reported about 5% to 15%. This research was done for ascertainment of level of knowledge, attitude and practice of employed nurses to nosocomial infection in teaching hospitals of Golestan University of Medical Sciences. Materials and methods: This is a descriptive and analytical study, total number of employed nurses (518), 189 male and 328 female. The research carried out using a questionnaire. The data was used to analyze the data SPSS software. Results: Results of research showed that 26.5% of nurses had very low knowledge, 63.9% medium knowledge and 9.6% good knowledge. About attitude 52.4% had negative attitude, 36.4% medium and 11.2% positive attitude. About practice 37.1% had poor practice, 49% medium and 15.9% good practice. In this research between attitude and knowledge, knowledge and practice there was not any meaningful correlation but difference between attitude and practice was statistically significant. Conclusions: The nurses are playing important role in prevention and control of nosocomial infection. So, it is necessary for nurses to have enough knowledge about how to control the infection and to have positive attitude, if they want to do their job property.

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Background & Objective: Hemodialysis patients quality of life is a significant subject. Style of coping or adjustment among hemodialysis patients is a complicated problem that affects the quality of life status. Responses domain to these problems are different from readjustment to suicide. The object of this study was to determine the relationship between quality of life and copings the problem, which were applied by hemodialysis patients. Materials & Methods: This is a descriptive analytical and correlational study. The study has been done in hospitals of Gorgan, Gonabad and Bandar Torkaman cities. The data were collected using a questionnaire with likert scale (From 1 to 5). Sample population was 167 patients. Results: The results showed that 89 patients were male, 78 patients female, 25.74% between 35-44 years old and hemodialysis of duration of 114 patients was more than 4 years. The quality of life mean score and standard deviatior were respectively 89.58, 8.13. About 75.42% of patient’s quality of life were moderate. The emotional and problem focused strategies were used in moderate way by the hemodialysis patients. Statistic tests between quality of life and emotional focused coping was significant (P<0.05). In general there are relationship between quality of life and total coping (P<0.05). Conclusion: According to study, we conclude that emotional focused coping and total coping influence the quality of life of hemodialysis patients. Therefore hemodialysis patients must be educated and supported, to cope with the problems.

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Background & Objective: Transureteral lithotripsy is an effective procedure in lower ureteral stone. This study was done to evaluate lithotripsy method in pediatric ureteral stones in Mashhad’s Imam-Reza Hospital. Materials & Methods: In our institute 38 patients went under ureteroscopy and lithotripsy for ureteral stones. Mean age in our patients was 6.8 years (Range 2-13 years). 16 patients were male and 22 patients were female. The mean stone size was 7 mm (Range 6-16 mm). Ultrasonography and KUB or IVP was performed in all cases. After general anesthesia and cystoscopy guide wire introduced in ureter, ureteroscopy were performed for lithotripsy used ultrasound pneumatic or electrohydrolic. Results: Stone were located in the distal ureter in 32 patients, in the midureter in 4 and in the proximal ureter in 2 cases. Ureteroscopy was successfully in 35 cases. Lithotripsy was used: Ultrasound, electrohydrolic or pneumatic. We were unable to introduce the ureteroscope into the ureter in 3 patients. In 3 patients stone migrated to the kidney after ureteroscopy. Then, they candidated for ESWL. Stone free was done in 32 cases (85%). A complication was 25% and treated with medical treatment. Conclusion: Our investigation demonstrates the high success rate ureteroscopy in pediatric group especially with a small caliber ureteroscope. Ureteroscopy should be considered the first choice for treatments of calculi in the distal ureter in children.

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Background & Objective: Ramsar a coastal city in the north part of Iran has among the highest levels of natural radiation known to exist in an inhabited area. This is mainly due to radium-226 and its progenies coming to the earth surface through hot springs. The health effect of low doses of ionizing radiation is not clear and is still under the matter of discussion. The study of the effects of high natural background radiation on human health was the main goal of this investigation. The present article is showing the results of the first phase of our work. Materials & Methods: This cross-sectional, analytical study was conducted on 101 families (402 residents) of high background radiation areas and 98 families (374 residents) from adjacent normal radiation areas. After description of the study and its objectives to the participants, they were asked to participate in interviews and complete questionnaires containing some socio-economic and health items. Some items of questionnaires were determined using the information recorded in local health centers in those areas. Results: Overall data showed no significant differences between the frequencies of any mental and physical disabilities as well as death, abortion and mental depression in residents of normal and high background radiation areas. However the frequency of some special diseases such as cardiac diseases and malignancies among residents of high background radiation area in comparison with ordinary radiation level areas was lower (P<0.05). Conclusion: These preliminary results, showed lack of ill effects and even some positive effects. Among population of high background radiation areas. Although we used census method for getting data, we believe that other radio-epidemiologic prospective studies can improve our knowledge about radiobiology of low doses of ionizing radiation.

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Background & Objective: Few studies concerning the effects of Opioid drugs on the function of immune system have been conducted and conflicting results have been reported. This study evaluates the in-vitro immune responses of drug abusers and investigates the pattern of production of IFN-? and IL-10, which represents the subsets of CD4+T-helper cells. Materials & Methods: Blood samples were taken from healthy drug addicted volunteers. Blood samples were also taken from healthy individuals with no history of drug abuse as control. Cell culture was performed in whole blood culture assay. Diluted blood samples were stimulated with phytohemagglutinin (PHA) and lipopolysaccharide (LPS) and the supernatants were collected to measure the Cytokine production. Results: The results demonstrated that a significant decrease in IFN-? production and increase in IL-10 production in Heroin addicts, whereas the production of these Cytokines in Opium addicts was not significant different from those in control group. Conclusion: The results indicated a significant decrease in mitogenic responsiveness of T-cells in Heroin addicts relative to control group, whereas mitogenic responsiveness of T-cells in Opium addicts was not significantly different from control group.

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Background & Objective: Anxiety and assertiveness lead to disorder achievement, destroying intelligence and learning abilities, decreasing thinking attention and declining talents. It causes damage to individuals, family and community. Several therapeutic procedures suggested such as drug therapy for solving anxiety and increasing assertiveness, one of none drug therapy (Behavioral therapy) is assertive training. In respect of contradiction of any results in the field of assertive training, we decided to design and carry out the present study. Materials & Methods: In study of field trial, first, we distributed overt and latent Spilberger’s anxiety questionnaire and Gambrilrichy’s assertive questionnaire among all nursing student’s of nursing and midwifery department of Nassibeh in Sari by sensus, and a number of 60 students with anxiety ranging were from moderate to sever with low assertiveness were selected, after matching than on the bases of sex, degree of interesting, course of study the degree, anxiety and assertiveness, they are divided in case and control group equally. For case group, assertive training performed during 6 weeks, once in a week for half an hour and no training is considered for control group. Degree of anxiety and assertiveness of nursing students in control and case group assessed and compaired by the use of couple T-test. Results: Couple T-test’s presented that decrease of overt and latent anxiety of nursing students in case group pre and post assertiveness training was significant (Latent anxiety, T=7.68, overt anxiety, T=4.97, P<0.05) on the bases couple T-test, increase of assertiveness degree in control group in pre and post assertive training was significant compairing to control group (T=-9.93, P<0.05). Conclusion: Regarding that increasing anxiety and decreasing assertiveness has undesirable effect on job performance, individual achievement and ability and with respecting to usefulness of assertive training procedure in decreasing anxiety and increasing assertiveness, it is suggested that assertive training is used as an on therapeutic procedure for decreasing anxiety and increasing assertiveness for nursing students.

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Background&Objective: Prolongation of QRS duration particularly in Left bundle Branch Block (LBBB) is commonly associated with many cardiac diseases. Electrocardiographic study of QRS duration and electrical axis may be predictors of sever LV systolic dysfunction. Materials&Methods: In this prospective Study conducted in cardiac ward CCU and out- patient clinic of Sh. Beheshti hospital in Babol (1999-2001), 150 patients with diagnosis of LBBB divided to two groups (one QRS≥0.16 second and the other with QRS<0.16) second . Then relationship between QRS- duration, Left axis deviation and echocardiographic LV ejection fraction analysed. Results: There wasn’t significant correlation between ages, gender, and type of cardiac disease with ejection fraction among patients with LBBB. The mean ejection Fraction in the patients with a QRS duration0.16 second (n=19) was significantly lower than the mean ejection fraction in the patients with a QRS duration<0.16 second (n=131) (P<0.05) Presence of Left axis deviation associated with LBBB did not have added predictive value and was not significantly correlated with Ejection Fraction. Conclusion: As conclusion, the QRS duration 0.16 second in the presence of LBBB has a significant inverse relation with Ejection Fraction and is a simple and appropriate marker of significant left ventricular dysfunction.

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Background&Objective: Surgery is an important stressor which makes some harmful physiological reactions shuch as high blood pressure, tachycardia, and repiratory distress. The aim of this study was to investigate the effects of music on the anxiety and some of physiological responses of patients before abdominal surgery, as assessed by objective parameters and a subjective validated questionnaire. Materials&Methods: This study is a semi-experimental study. Total of 134 subjects was randomly assigned to undergo either 20 minutes of music intervention or a rest period. The level of anxiety was measured using Spilberger questionnaire and physiological responses, arterial blood presure, heart rate and respiratory rate. Subjects in intervention group listened to 20 minutes music by Johann Sebastian Bach. The control group listened to no music. The anxiety level and physiological responses were measured before and after intervention. Results: There was no significant difference between the anxiety level and physiological responses in two groups of subjects before intervention. The findings indicate a significant statistical difference in the level of anxiety and mean of arterial blood pressure in the intervention group (P<0.05). There was no significant difference in heart and respiratory rate in two groups of subjects. Conclusion: As indicated by the results of this study, music can provide an effective method of reducing potentailly harmful physiological responses arising from abdominal surgery, therefore it is suggested to use it before surgery.

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Background&Objective: Low back pain (LBP) is common in youth, although `associated with chronic pain in adults. The purpose of this study was to determine the prevalence and risk factors of LBP in school children age 11-14. Materials&Methods: A cross sectional study was carried out on school children aged 11-14 in north of Iran. Using random multistage sampling 5000 children were selected. Demographic, mechanical and lifestyle data as well as the prevalence and LBP characteristics were collected by a questionnaire. Data analysis was carried out using SPSS (version11) software. Results: Of the original sample, 4813 (96.2%) children returned the questionnaire. Point, last month, last 6 months and annual prevalence were 15%, 14.4%, 15.6%, and 17.4%, respectively. LBP was significantly correlated with age (p<0.05), lifting (p<0.05), position and duration of watching TV, doing homework and duration of exercise (p<0.05). Conclusion: The results indicated that the prevalence of LBP in school children is relatively high. Further studies evaluating the effect of different preventive strategies to reduce the prevalence of LBP in school children is strongly recommended.

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Background&Objective: Decrease in production of erythropoietin has been noted as one of the main factors causing anemia in ESRD patients, and administration of recombinant human erythropoietin (rhEPO) has been used to correct the anemia. Iron deficiency, including functional iron deficiency, limits the efficacy of rhEPO therapy in ESRD patients. This study examined the effects of maintenance intravenous iron sucrose (Venofer) on haemoglobin level and, optimization of erythropoietin therapy. Materials&Methods: Forty eight haemodialysis patients with haemoglobin level<9 gr/dl who were dialyzed three times weekly went under the study. Two thousands units of rhEPO were given subcutaneously at the end of each dialysis for seven weeks. At the end of the seventh week, those with haemoglobin level<9 gr/dl and with ferritin level <200 ng/dl (29 patients) were chosen for intravenous administration of 100 mg Venfor during the next five consecutive haemodialysis while maintaining the rhEPO dose at 2000 units with each dialysis. A week after the last dose of Venofer, haemoglobin and serum ferritin were determined. Results: Average haemoglobin level among the patients before administration of rhEPO was 7.5 gr/dl. After seven weeks of subcutaneous rhEPO at 2000 units with each haemodialysis, the average haemoglobin level raised to 8.5 gr/dl. The effect of maintenance IV Venofer was an increase in average haemoglobin level to 10.4 gr/dl. The same effect was seen on the ferritin level. The ferritin level of 131 ng/dl increased to 237 ng/dl a week after last dose of IV venofer. Conclusion: Intravenous (IV) iron improves haemoglobin response and, thus, optimizes rhEPO therapy.

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Background&Objective: Polycystic ovary syndrome (PCOS) seems to be the most common endocrine disease in women of reproductive age. This study has shown that PCOS is associated with hyperlipidaemia and hypertension. The aim of this study was to compare the cardiovascular risk factor in PCOS and normal women. Materials&Methods: It is a case – control study that was done on 60 barren and non-affected women and 60 barren women affected to PCOS that had clinical examples and sonographic PCOS. All of women were studied from the characteristics point of view such as age, BMI, the size of around waist and buttocks, time and kind of infertility and Blood pressure. Necessary tests were done such as total cholesterol, LDL, HDL triglyceride, insulin level and fasting blood sugar. Data were analyzed with SPSS. Results: Triglyceride, cholesterol, LDL and BMI of the patients affected to PCOS were significantly higher than normal women (P<0.05). HDL level reduction was significant in patients affected PCOS (P<0.05), also systolic and diastolic blood pressure in affected women was higher than control group (P<0.05). Conclusion: PCOS women have higher cardiovascular risk compared to normal women.

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Background & Objective: Burnout is a syndrom that emerges by mental fatigue and loss of competency. Inappropriate pysical Environment and Professional Equipment may be caused Burnout in nursing. Therefore this study accomplished by object of determination of relationship between Burnout and physical Environment and professional equipments. Materials & Methods: This is a descriptive –analytical corrolational study. The environment of study was medical sciences hospitals and samples were nursing emploees in 1383-84. The research tools were two questionnaire including Maslach Burnout Inventory (MBI) consisted of three partsincluding: Emotional exhaustion, depersonalization and personal achivement. the next, was pysical Environment and Professional Equipments questionnaire. Results: Total participants were 272 nurses that43.8% of them had high level of emotional exhaustion, also there were a significant relationship between emotional exhaustion, dpersonalization and physical environment (p ? 0.05). In adition, there were a significant relationship between severity of emotional exhaustion and dpersonalization with professional equipments (p?0.05). There were a reversed relationship between burnout and professional equipments desirability. Conclusion: This study indicated that most of the samples had high emotional exhaustion and there were relationship with physical environment and professional equipments. Also there were a reversed relationship between burnout and professional equipments desirability.

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Background&Objective: Two enzymes have the ability to hydrolyze acetylcholine. One is acetylcholinesterase, which is called true cholinesterase, it is found in erythrocytes. The other cholinesterase is pseudocholinesterase, it is found in serum. Some chemical components of organophosphates group and carbamates affected cholinesterase activity. Determination of cholinesterase has application in diagnosis of liver disease, liver damage by insecticide and assessment of fatty liver. Pesticide factory workers are one group of peoples which are exposed of poisoning by pesticide. Materials&Methods: This research in 2005 performed in pesticide producers. In two stages (3 month interval) from 58 of personal blood was drown. Results: Mean of erythrocyte cholinesterase in first stage was 48.5±11.2 IU/gHb and second stage was 37.9±17.3 IU/gHb. Decrease of erythrocyte cholinesterase was significant differences (paired t test, P<0.05). Increase of serum AST was not statistically significant. Increase of serum ALT and Albumin was significant differences (paired t test, p<0.05). In 15 individual (25.9 %) cholinesterase decrease more than 35% and in 16 workers (27.6 %) erythrocyte cholinesterase decrease between 26-35%. Conclusion: Since in more than 26% of personnel cholinesterase decreased over than 35%, routine assessment of cholinesterase in similar factory, is recommended.