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Background&Objective: High blood pressure (BP) is one of the most important health problem world-wide (2005), and risk factor of cardiovascular diseases. This study was determine the prevalence of high blood pressure (BP) among urban subjects in Golestan of province, during 2005. Materials&Methods: This cross sectional study was done on 5000 subjects of 17-70 years old in different towns of Golestan province during 2005. Two equal ratios of both sexes were selected on random clustering sampling in the morning and afternoon. A questionnaire consisting of demographic data and clinical information such as electronic presser gauge filled by trained persons. All of the data analyzed using spss-11.5 and descriptive statistics. Results: The result showed that 2500 male (50%) and 2500 (50%) female, ethenicity were (4.6%) Torkaman, (18.9%), and Sistani (76.4%) Fars group from age of 17 to 70 years old. This study on this basis criterion JNC-5 (46.4%) all of studied subjects had blood pressure normal, (22.6%) blood pressure high normal (21.4%), blood pressure light (7.4%), blood pressure medium and (2.2%) blood pressure severe. Conclusion: The prevalence high blood pressure among the urban population in this province in this province was 31%. Which is slightly higher than other regions in Iran and other part of the world. This issue can be considered in the health planing and theraputic programs in the region.

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Background & Objective: Hypertension is the most important Cardio-Vascular risk factor, and also the most common cause of heart failure, stroke and renal failure. This semi-experimental study aimed at determining the effect of education, by means of Health Belief Model (HBM), on nurse’s staff knowledge, attitude and their practice toward hypertension. Materials & Methods: This semi-experimental study was done on 136 nurse’s staff selected by stratified random sampling. Data collection instrument were a questionnaire and a check-list. At first, the subjects’ knowledge, attitude and their Practice were studied by a questionnaire and a check list, and then a HBM-based educational program was carried out. For three months, Afterwards, their knowledge, attitude and practice were measured and compared with pretest findings. In statistical analysis, Wilcox on test, independent t test, ANOVA and Pearson correlation. Results: Before education the mean score of knowledge, benefit perceived, barrier perceived, threat perceived, attitude and practice was 9.68, 23.76, 25.63, 22.82, 71.99 and 4.55 respectively. After education these scores reached 16.66, 26.06, 28.94, 24.98, and 80.08 and 4.83. Based on the results, nurse’s staff training via HBM led to high knowledge, positive attitude and practice improvement (p<0.05).The difference between this research variables such as age, gender, marital status, record of service and family background was not significant, But there was significant difference between variables (occupational levels, educational levels, and hospital ward) and knowledge and practice. Furthermore, the relation between hospital ward and attitude was positive (p<0.05). Conclusion: In terms of the results, it is a necessity for nurse’s staff to participate in a HBM based educational program.

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Background&Objective: Dyspnoea and fatigue caused considerable impairment in the functional performance and quality of life in HF patients. The purpose of this study were to determine efficacy of home walking exercise program on functional performance and quality of life in patients with heart failure. Materials&Methods: This study was qusiexperimental trial that assessed efficacy of home-based exercise program on the functional performance and quality of life in patients with HF in the Ahvaz city (2005). In this study 60 patients with New York Heart Association (NYHA) class II and III heart failure divided two groups training (n=30) and control (n=30). Material or measurements was demographic characteristics form, Minnesota quality of life check list and timed exercise program form. Exercise training in the patients would be performed tree day per week for 8 weeks. Determination quality of life measures by Minnesota check list would be performed in both the training and control groups at entry and after 8 weeks. Also 6 minute walking tests for determination functional performance would be performed in both groups at entry and after 8 weeks. Ultimately data analysis by SPSS softward. Results: results showed that significant difference existed between mean walking distance on the 6MWT at entry and after 8 weeks in the training group (373.86 to 412.30 m, P<0.05), that no significance was seen between control group (376.79 to 377.63 m). Also significant difference exists between mean quality of life scores at entry and after 8 weeks in the training group (52.32 to 43.80), that no significance was seen between control group (52.43 to 52.50). Conclusion: This study showed that home-based exercise program affected on functional performance and quality of life in HF patients. Its accepted. Therefore exercise training can be used as a therapeutic approach in these patients, because not only promotes quality of life but also improve the functional performance.

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Congenital dislocation of radial head without any abnormality is rare,and commonly reveals with anomalies in another organs.it can be appearance in one side or two side be cause of late manifestations,diagnosis of congenital dislocation of radial head is usually difficult. It is more important to recognize congenital anomaly of radial head from dislocation of elbow that events in trauma.this article presents one case of congenital dislocatin of radial head that is involved one side with out any anomaly.

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Background&Objective: The present study was designed to investigate the outcome of pregnancy and delivery in pregnant Iranian women with low and high hematocrit. Materials&Methods: In a cohort control study, 609 pregnant women attending Yahyanejad Hospital for antenatal care and delivery from Dec 2001 to Dec 2003 were randomly selected. Women with hemoglobinopathies such as thalassemia were excluded from the study. Maternal characteristics including hematocrit values were recorded at the first antenatal care and 3 cc.blood was sent to the laboratory for CBC. The main outcome measures included birth weight, gestation at delivery, Apgar scone, mode of delivery,the admitted NICU and perinatal death. X2, T-test, Anova and logistic regression models were also applied to analyze the data. Results: Anemia (hematocrit<34%) in the first trimester was associated with a significantly increased risk of low birth weight (<2500g) and preterm delievery (<37 week’s gestation). High hematocrit values (>40%) did not increase the risk of low birth weight or preterm delivery. The risk of low Apgar score, operative deliveries and admitted NICU was significantly increased in women with high and low hematocrit adjusting for maternal age, parity, weight gain, inter pregnancy, father and mother education and other confounding factors. Conclusion: Low and high maternal hematocrit in the first trimester can contribute to the adverse pregnancy outcomes, thus pregnant women with abnormal hematocrit are at high risk factor and necessary awareness should be given to them on how to prevent complication and adverse outcome by special clinical care.

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Background&Objective: Teacher’s mental health, due to its effect on the formation of attitude and mental health of students, play more important role than any other social-class. This research focuses on the extend of teacher’s mental health with various levels of education as its main objective. Materials&Methods: This is a descriptive cross-sectional research. Statistical population is comprised of all teachers in Golestan province who involved teaching at schools in the educational year of 1383-84. a sample of 535 teachers was obtained through multi-phase random cluster sampling. Symptom checklist questionnaire with a cut-point of 2.5 on each dimension and 1.3 cut-point for global symptom index (GSI) were considered in determining teacher’s mental disorder. Results: Finding showed %81.1 of teachers are of sound mental health and %18.9 of them (%21.8 in female and %14.9 in mal) seem to suffer at least from one of the symptoms of mental disorder. The sequence of disorder symptom prevalence was as follow: somatization %7.3, paranoid ideation %5.8 and depression % 4.9. the highest mental disorder was seen among elementary school teachers(%21.6) and the lowest among senior high school teachers(%14.9). a significant correlation coefficient between teacher’s level of education and overtime work with global symptom index(GSI) was seen(P<0.05). Conclusion: Result of study showed that the prevalence of mental disorders among Golstan teachers are medium and this finding are indicative of lower mental disorder among the teachers in Golestan province in comparison to the finding of similar researches done in other provinces.

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Background&Objective: Pain, in particular post-operative pains, can produce numerous complications including a delay in healing of wounds in patients. For pain relief in patients postoperatively, different drugs are used, opioids like pethidine and NSAIDs. This study was carried out to compare the effects of the IM pethidine and suppository Diclofenac for pain relief after laminectomy following lumbar disc hernia.
Materials&Methods: this is a randomized control clinical trial study, 100 patients presenting for laminectomy with diagnosis of lumbar disc hernia and eligible for participation in the study, after recieving their informed consent for inclusion in the study non probability convenience sampling were selected by a convenience sampling method and then divided into two groups of Pethidine (P) and Diclofenac (D). Patients’ pain scores were measured by Visual Analogue Scale (VAS). Finally, the data obtained were analyzed by statistical software of SPSS.10, F test, T test and ?² P<0.05 was considered significant.
Results: Mean pain scores within 24 hours after operation were calculated in group P as 2.8±2.02 and in group D as 4.46±2.30. There was a statistically significant difference between the reduction of the pain score after surgery in both groups (p<0.05). Nausea was the greatest side effect observed in group P (23%) and epigastric pain was the most common pain found in group D (18%). However, no statistically significant difference was found between the two groups in terms of the drug adverse effects.
Conclusion: A statistically significant difference was observed between pethidine ampule and Diclofenac suppository regarding the pain reduction after laminectomy. In the other words, Diclofenac suppository has less impact on pain killing in comparision with Pethidine ampule. In other to confirm these results, it is suggested that another study in terms of age and sex and after orthopedical procedures in a large scale-and if possible double blind- to be carried out.

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Background & Objective: We have two areas in gluteal region for intramuscular injection‚ Ventrogluteal and Dorsogluteal. This study was done to compare pain intensity and bleeding rate after injection in Ventrogluteal and Dorsogluteal area.

 

Materials & Methods: This clinical trial study was done on 67 males in 5th Azar hospital in Gorgan north of Iran. Patients had 2 injections during 24 hours. For every patient one injection was done in Dorsogluteal area and the second injection was done in Ventrogluteal area. For every patients the pain intensity and rate of bleeding for every injections recorded. Data analyzed by SPSS-11.5 software and Kolmogorov-Smirnov and Wilcoxon tests.

 

Results: In Dorsogluteal area 83.5% of patients had a low and medium pain‚ where as in Ventrogluteal area 88% of patients had a low and medium pain and 9% of them had not any pain. The Mean±SD of pain intensity in Dorsogluteal area was 50.79±1.682 and in Ventrogluteal was 40.79±1.878. The Mean±SD of bleeding in Dorsogluteal and Ventrogluteal areas were 0.73±0.102 and 0.19±0.047 respectively. There were significant differences in pain intensity and bleeding between two groups (P<0.05).

 

Conclusion: We concluded that the injection in Ventrogluteal area has a less pain and bleeding rate in comparison with Dorsogluteal area.

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Background & Objective: Nutritional support is a basic process for survival in trauma patients. The purpose of this study was to evaluate the daily nutritional support practice in head injury patients admitted to Neurosurgery Intensive Care Unit.

 

Materials & Methods: This descriptive cross-sectional study was done on 115 Head injury adults patients who received enteral nutrition for at least 48h in Rasht Poursina hospital during 2005. Nutritional measurements were included the number of patients who received enteral nutrition, the time to initiate nutritional support, amount of initial feeding and clinical outcome were included the duration of mechanical ventilation, ICU and in-hospital length of stay (loss), in-hospital mortality rates .Data was reported as Mean±SD and percent. T-test analysis was used for comparing of calorie and nutrient intakes and requirements.

 

Results: Mean±SD of age patient was 41.22±21.9, 84% of patients received enteral nutrition. The time to feeding and the amount of initial feeding was 4.6±1 day and 52.79±27.83 ml/h respectively. Duration of ventilation was 12±13.4 day and ICU length of stay 18.96±18.3 day, Hospital length of stays 24.47±19.84 day. Mortality rate in six month was 48%. Mean of energy, carbohydrate, fat and protein (P<0.05) intakes had significant differences compared with requirements.

 

Conclusion: The recording process has revealed undesirable feeding practice in head injury patients. Nutritional outcomes would be improved with implementation of standard protocol in neurosurgery intensive care unit.

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Background & Objective: At least about 30 percentage of children hospitalize in hospital in their childhood. Hospitalization of children cause anxiety, due to separation from their parents ,fear of new environment, disabilities and continuation of life. This study was done to determine the effect of music on the rate of anxiety among 9-12 years old hospitalized children.

 

Materials & Methods: This semi experimental study was done on sixty 9-12 years old children who are confined to bed in Taleghani hospital in Gorgan north of Iran during 2002-3. 60 of children were divided to 2equal groups of intervention and control randomly. The tools of gathering data including information questionnaire, patients demographic, state – trait anxiety inventory for children Spillberger (STAIC), face anxiety children examined scale Piyeri (FACES) information was compared before and after the intervention the collect. For intervention group, 2 music therapies listening of music section, for the 2 continuous days and each section lasted for 20 minutes. The collected data before and after intervention were analyzed by using Kolmogrov-Smironov, c², independent-sample T test, Wilcoxon signed Ranks, Bartlet and Mann Whitney test.

 

Results: There was not any difference between the average of state anxiety and amount of face anxiety in both group before execution of music therapy but there was a significant difference for the intervention group after the music therapy (p<0.05). Also the decrease in the rate of anxiety in intervention group can related to the executing of music therapy.

 

Conclusion: Music therapy reduced the rate of anxiety among the 9-12 years hospitalized children.

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Background & Objective: in recent years antibiotic resistance of Pseudomonas aeruginosa is increased as a causetive factor in hospital contamination. This study was done to determine the prevalence and antibiotics susceptibility of Pseudomonas aeruginosa isolated from inanimate objects in Taleghani hospital.

 

Materials & Methods: This descriptive study was done on inanimate objects in different wards of Taleghani hospital during 2006. Sampling was performed by sterile gauze pad for dry surfaces and swab for wet surfaces. To differentiate and identify P.aeruginosa, various culture media such as Brain Heart Infusion Agar, Citrimide Agar and Triple Sugar Iron Agar were used. Antibiotic sensitivity of the isolated strains was determined by Kirby-Bauer Method using Muller-hinton Agar medium. Moreover, antiseptic sensitivity of the strains to Decosept and Povidone-Iodine as the main antiseptic agents was identified by determining Minimal Bactericidal Concentration and Minimal Inhibitory Concentration using Nutrient Agar and Nutrient Broth media.

 

Results: Fifty-five of the total 292 samples were positive for P.aeruginosa. Based on the ratio of the number of positive samples to the total samples, Thalassemia ward (38.5%) was the most infected ward and taps (61.1%) was the most infected sampling place. None of the samples from room atmosphere and intensive care equipments were positive for P.aeruginosa. 20% of the samples were resistant to ceftazidime and 32.7% were resistant to piperacillin, also 10.9% of samples were resistance to both ceftazidime and piperacillin.

 

Conclusion: This study showed that contamination with P.aeruginosa and antibiotic resistance of the isolated bacteria are the main problems in Taleghani hospital.

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Tibiotalar dislocation without concomitant fracture in the surrounding bones is a rare injury. We report one of them presenting unreduced after a 10 month interval. A 23 y/o female presented to our clinic 10 months after Bam earthquake, during which she had sustained an anterior tibiotalar dislocation without any associated fracture. Open reduction was tried two times, but both attempts were unsuccessful because of the very poor quality of bone. Although ankle dislocation has been reported to be associated with good prognosis, it was not the case with our late presenting patient.

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Background & Objective: Enteroparasitic infections constitute a serious public health problem in different populations including developed countries. Patients who receive chemotherapy of cancer have an increased probability of acquiring parsitic infections, generally with a high degree of severity. The aim of present study was to ascertain the frequency of intestinal parasites in patients admitted in oncology ward for chemotherapy. Materials & Methods: In a descriptive study, all the patients whith malignancy who admitted in Sina Hospital in Hamadan, Iran, during 2005 were included. Data including demographic characteristics, type of malignancy, and the time past from the diagnosis entered the questionnaires. A stool specimen were examined for each patients. Data were analyzed using SPSS software. Results: Out of 190 patients, 94 (49.5%) were male and 96 (50.5%) were female. The mean age was 48.518.7 years (12-88 years). Thirty-one (16.3%) patients were involved intestinal parasites. The most common parasites were: Ascaris (41.9%), Giardia (35.5%), Indolimax nana (3.2%), Blastocytis hominis (3.2%), and Cryptosporidium (3.2%). The highest prevalence of intestinal parasites belonged to 40-60 years age group Conclusion: This study indicated that, the prevalence of intestinal parasites in patients undergoing chemotherapy for malignancy is lower than general population, which can be related to the effect of antineoplastic agents.

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Background & Objective: Hepatitis B virus (HBV) infection is one of the most important health problems all over the world. This study was conducted to determine the co-infection of hepatitis C virus (HCV), hepatitis D virus (HDV) in HBV infected patients in Golestan province of Iran. Materials & Methods: This population based cross sectional study was done in 2004. 139 HBsAg positive cases were assessed for co-infection with HCV and HDV. Serologic tests were done by ELISA method using available kits. Data were analyzed by SPSS-12 and STATA8 software. P-values of less than 0.05 were considered as significant. Results: Sixty eight (48.9%) of 139 cases were males and 71 (51.1%) were females. The mean (±SD) of participant's age was 41.89 (±11.3) years (range: 25-64 years). Anti-HCV and Anti-HDV antibodies were positive in 17 (12.3%) and 8 (5.8%) cases, respectively. Females were more infected with HCV and HDV than males. But the differences were not significant. Conclusion: The prevalence of co-infection with HCV and HDV in HBV infected cases is relatively high and notable in Golestan province of Iran. Because of negative effects of these co-infections in clinical outcome of the disease, it is recommended to assess possible HCV and HDV infection in individuals with HBV infection. This may result in more efficient management of the disease.

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Background & Objective: In addition to pyramidal neurons and interneurons, the hippocampus contains Astrocytes that play important roles in regulating ion flux currents, energy production, neurotransmitter release and memory. Learning needs some instrument for information storage and information maintenances mechanisms resemble to memory. The aim of this study was determination of spatial memory effect on the number of astrocytes in rat’s hippocampus. Materials & Methods: In this experimental study, with usage of Morris Water Maze and Reference memory technique, we used 10 male albino wistar rats. 5 rats were in control group and 5 rats in Reference memory group. After histological preparation, the slides were stained with PTAH staining for showing the Astrocytes. Results: The findings of this study showed significant difference in astrocytes number in CA1, CA2 and CA3 area of hippocampus between control and reference memory group. The mean and SD of astrocytes in CA1, CA2 and CA3 of reference memory group were 118.57±25.29, 58.91±23.59 and 116.6±31.14, that they are more than control group with 49±17.29 in CA1, 48.8±25.21 in CA2 and 41.95±11.22 in CA3. Conclusion: We concluded that the number of astrocytes increased due to spatial learning (e.g. reference memory method).

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Background & Objective: Despite their very wide geographical distribution in the Mediterranean region, most Leishmania infantum strains belong to zymodeme MON-1. As different Leishmania species are known to cause different clinical symptoms and may require different treatment protocols, therefore this study was done to identify and characterize the leishmania agents causing visceral, Leishmaniasis (VL) in humans, reservoirs and vectors in the north-west of Iran by Isoenzyme analyses. Materials & Methods: In this descriptive and cross sectional study, The samples collected from 12 VL confirmed patients (bone marrow aspirates), 26 dogs (spleen and hepatic aspirates) and more than 100 sand flies from northwest of Iran between 2005 and 2006. All aspirated material from human, canine and sandflies demostrated growth of Leishmania parasite in NNN and αMEM media. The above species compared with WHO reference strains, Leishmania (Leishmania) donovani (DD8), L (L) infantum (IPT-1), L (L) tropica (K-27), and L(L) major (5-ASKH), using thin layer starch gel electrophoresis. The enzymes investigated in this study were ALAT, ASAT, SOD, ES,NH, MPI, GPI, MDH, 6PGD, PGM, PEPD, and PDK. Results: In this study L.infuntum. MON-1 was the only zymodeme present in all samples of dogs and human sandflies. Conclusion: We concluded that the visceral Leishmania (VL) focus in northwest of Iran is evidently Mediterranean type, which extends from Portugal and Morocco to Pakistan and the Central Asia and domestic doges act as the reservoir host in northwest of Iran, where the complete life cycle of zymodeme MON-1 has been identified.

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Background & Objective: More than 50% of patients with hypertension will have end organ damage (such as: CHF, retinopathy ,CVA or renal failure).Left ventricular hypertrophy (LVH) is an independent risk factor for death and cardiovascular disease .Both renal dysfunction and LVH are signs of end organ damage so we carried out this study to evaluate the correlation between LVH in echocardiography and kidney function in patients with essential hypertension. Materials & Methods: This descriptive analytic study was carried out on 102 patients whome reffered to 5 Azar hospital in Gorgan- Iran, suffering from essential hypertension and had proved LVH in echocardiography with no other disease during 2005-6. Kidney and urinary tract assessment such as serum BUN, Creatinine level and kidney sonography was done on subjects. Left ventricular hypertrophy was defined as a left ventricular mass index (LVMI)>=135g/m2 in men and>=110g/m2 in women. Renal function was estimated by means of the serum Creatinine level and proteinuria and sonographic findings of kidney and urinary tract. Data was analysed by Spss-11.5 and Chi-Squre test. Results: The average age of patients were 60±8.8. 58%, 36% and 7% of patients had mild, moderate and sever LVH respectivly. The means of Creatinine and BUN level were 1.09±1.12 mg/dl and 20.6±10.76 mg/dl had direct correlation with kidney dysfunction (P<0.05). There was a significant relationship between LVH severity and presentse of Kidney scar in sonography (P<0.05). Conclusion: This study showed that a very large fraction of the subjects with essential hypertension have kidney problems. Therefore, serum BUN and Creatinine level and sonographic scar of kidney can be reliable markers for assessing and controlling target organ damages that are induced by Essential hypertension.

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Background & Objective: ADHD is the most common mental disorder in children. Awareness of students' mental health has an important role in programming for decrementing their disorders and, improving their mental health and also preventing the complications of their decreased mental health. The aim of this study was to determine the prevalence of ADHD and some of the affecting factors among school children in Nishaboor localed in the North – East of Iran. Materials & Methods: This descriptive study was done on school children in Nishaboor during 2006. Subjectes selected by stratified cluster sampling. Data collection was done using the Conner's Parent and Teacher Scale questionnaire, and each student's questionnaires were completed by both the teacher and the parents. Data analysis was performed regarding to the mean scores of teachers and parents. The score 15 was chosen as the probable indicator for ADHD. Results: 722 students (79.6%) were involved this study. Prevalence of ADHD was 12.5%, CI95%: 10–14.8%. There was no significant difference in gender distribution. The prevalence of ADHD had a significant rise with age (P<0.05). The highest prevalence was in spring born and the lowest was in the summer born school children (P<0.05). The prevalence of ADHD had a significant relationship with father's education and was lower in students whose father had higher educations (P<0.05). Variables such as type of delivery, pariety, mother's education had no significant relationship with the prevalence of ADHD. Conclusion: In this study the prevalence of ADHD is higher than similar studies. Risk groups to be followed up by the responsible organizations.

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Background & Objective: Monitoring the depth of anesthesia is very important to prevent undesirable events during surgery, such as intra operative awareness and overdosing. It is shown that anesthetic agents have direct effects on synaptic activity of brain neurons. So there is a great interest on electroencephalogram analysis as a depth of anesthesia estimator. Due to difficulties in visual explanation of EEG, automatic and computer based signal processing methods have been used to assess the depth of anesthesia. Investigating the relationship between conscious level of patients and electrical activity of brain neurons was the main aim of this study. Materials & Methods: In this study, EEG signals of six patients undergoing aortic valve replacement surgery have been acquired and recorded in a computer. After applying signal processing methods to these data, 3 different measures included temporal, spectral and bispectral parameters have been extracted. Mean values of mentioned parameters in different anesthetic regimens and levels have been analyzed by ANOVA in SPSS software. Results: Extracted temporal parameter is correlated with depth of anesthesia in deep anesthetic levels and spectral one is correlated with depth of anesthesia in moderate and light levels (P<0.05). Bispectral parameter is correlated with the depth of anesthesia only in ICU (P<0.05). Conclusion: Findings of this study confirm the relationship between consciousness and electrical activity of brain neurons and recommend the use of EEG processing techniques to monitor, control and estimate the depth of anesthesia in operating room and ICU ward.

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Background and Objective: Depression is the most common mood disorder. To assess the incidence and wide spread of depression and associated factor among of Bakhteyari tribal as native population in Chaharmahal and Bahkteyari province, this study was conducted. Materials & Methods: This study was a descriptive and cross-sectional study which was carried out on 400 subjects by using a systematic random sample technique during 2006. Depression was assessed by Beck inventory depressive questionnaire. Data was Analyzed by SPSS-11 Software and t-test , Chi-Square , ANOVA. Results: Mean±SD of depression score in female and male were 18.5±10.8 and 14.9±11.45, respectivly. Depression incidence rate in population was 29.6% (CI 95%: 25.6-33.6). Intermediate and upper degree of depression prevalence was determined to be 24%. The incidence rate of descriptive in female was higher than males (P<0.05). There was a significant relationship between depression in house wife and jobless people (p<0.05). The highest incidence rate was either under 20 years or above 50 years old. Conclusion: This study showed that the depresion rate is higher among the tribe than in other groups in this province.