Yafteh

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Mardani M1, Mohsenzadeh A2, Dehestani Ardakani Gh3, Birjandi M4 1. Assistant Professor, Department of Nutrition, Faculty of Medicine, Lorestan University of Medical Sciences 2. Assistant Professor, Department of Pediatrics, Faculty of Medicine, Lorestan University of Medical Sciences 3. GP, Lorestan University of Medical Sciences 4. Instructor, Department of Epidemiology, Faculty of Health, Lorestan University of Medical Sciences Abstract Background: Numerous studies indicate that diarrhea is more common in persons suffering from malnutrition, because malnutrition causes infection and infection leads to diarrhea which in turn it is a notorious defective cycle. Regarding the high prevalence of gastroenteritis, especially in less than 2 years old children, and relatively high prevalence of malnutrition in children in developing countries that cause impacted high expenses on government and families, because of long term hospitalization of children, this research was carried out to study relationship between nutritional status of children with gastroenteritis and their duration of hospitalization in Khorramabad Shahid Madani hospital in 2007. Materials and methods: In this cross- sectional study, 100 children under 2 years old with gastroenteritis were investigated. They were divided into groups of 50 including well nourished and mal nourished, then the duration of hospitalization in both groups was compared. Nutritional status of the children was measured by dividing their weight by their 50% of standard weight for their ages. Children with birth interval from previous child more than 2 years, birth weight over 2500 grams, mothers’ age range of 20-35 years, lack of hospitalization during the last 6 months were selected. Data were collected using questionnaire. The effect of the other likely interfering variables, with 95 percent of confidence interval, were determined. Results: A significant relation between mean time of hospitalization (in terms of day)and nutritional status of the children was observed (P<0.001) mean time of hospitalization in well nourished group was 2.58 days, however in mal nourished group it was 3.86 days. Among interfering variables, only exclusive breast feeding showed a significant effect on the duration of hospitalization (P=0.001). Most of the children suffering from gastroenteritis were between 7-12 months of age. Mean age of mal nourished children was 8.96 months, while for well nourished children it was 10.18 months. Conclusion: According to our results, malnutrition leads to a significant increase in duration of hospitalization in children suffering from gastroenteritis disease.

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Background: Borderline Personality disorder is a disabling disease affecting 2% of general population. Various drugs have been suggested for treatment of borderline Personality disorder. If a drug could alleviate a wide range of symptoms, it would be more suitable. In these disorders drug addiction is very common. This fact makes the symptoms complicated and the treatment more difficult. This study is designed to evaluate the effect of Olanzapine and Sertraline in patients suffering from personality disorders who are on methadone maintenance therapy.

Materials and Methods: This clinical trial study was carried out on 120 male and female cases chosen for methadone maintenance therapy through interview by a psychiatrist based on DSM-IV-TR diagnostic criteria for BPD. Afterwards they were randomly divided into two groups. These groups separately received Olanzapine (5-10 mg daily) and Sertraline (50-100 mg daily) therapy. The SCL-90 questionnaire was filled out by the participants before treatment and at the 4^th, 8^th and 12^th weeks of the treatment.

Results: According to this clinical trial, Olanzapine and Sertraline were effective in ameliorating symptoms of depression, anxiety and aggression, reducing sensitivity in interpersonal relationship and alleviating obsessive symptoms, pessimistic behaviors and somatization disorders in patients with personality disorders on methadone maintenance therapy.

Conclusion: As results of this study stated that Olanzapine and Sertraline are definitely effective in alleviating symptoms of patients with personality disorder, prescribing theses drugs are highly recommended for these patients.

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Background: Because of predisposing risk factors, prevalence of HIV & HCV in different countries has been reported with different percentages. Co infection of HIV & HCV in patients could have additional effects on infection process, persistence and prevalence rate. The purpose of this study was assessing prevalence rate of these infections especially co infection of HIV and HCV in patients.

Materials and Methods: This descriptive and cross sectional study, was carried out on suspected patients of HIV and HCV referred to Khorramabad Shohadaye Ashayer hospital, in 2007. Patients’ serums were evaluated by ELISA for the presence of specific Antibodies. Collected data was analyzed using SPSS software. Fishers exact test with 5% error intervals was used for correlation of sex and infections rate.

Results: 304 and 116 of cases were men and women respectively. Results of the study indicate that 45(10.7%) of the cases were HIV positive (10% men and 0.7 % women) and 115 (24.8%) cases were HCV positive (20.3% men and 4.5% women).

Co infection rate for HIV and HCV was 8.1 % out of 420 total cases. 75.6 % of HIV positive cases were co infected with HCV. Co infection of HIV with HCV was significantly correlated. (p <0.001)

Conclusion: Because of high prevalence of HCV co infection in HIV patients its likely that HIV positive individuals have greatest risk of acquiring HCV infection and vice versa. Co infection rate of HIV & HCV in our country may be higher than other countries.

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Background: Legionella is a negative aquatic bacterium and one of the most common nosocomial pathogen. Hospital environment in case of growth, aerosol transmission system and endangered individuals are the high potential location for growth and prevalence of this agent. The suitable temperature in water reservoirs and water distribution system empowered the growth of this bactria. The purpose of this investigation is the study of legionella presence in khorramabad water distribution system.

Materials and Methods: Sampling performed with fifteen-day periods of each cold and hot hospital water reservoirs and also cold and hot water taps in those hospital wards which have more pathogens. Each of samples concentrate high vulnerable membrane and from each sample 2 plates were cultured with BCYE and GVPC optional culture media and the growth of bacteria in third and seventh and tenth days were controlled and registered.

Results: From 240 samples of five Khorramabad hospitals 41.7 percent of the samples were positive. The percent of positive samples of Ashayer, Tamin ejtemaee, Tohid, and Asalian were respectively 68.8, 45.5, 33.3, 9.1 and 36.4 percent and the residual mean chlorine of samples were respectively 0.38, 0.52, 0.46, 0.82 and 0.62mg/l. The most positive samples related to hot shower and the lowest value related to cold water taps.

Conclusion: In spite of the fact that all hospitals used treated water, but from 240 collected samples, 100 samples in different sections of hospital were positive these results show direct relation between residual chlorine value and presence of legionella, by the manner that in 0.6 mg/l and higher values of residual chlorine none of samples were positive. So usually the residual chlorine value in water distribution system is not enough to legionella against.

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Results of thoughts, activities and measures taken in each organization are maintained as documents and records these records, which are created by spending great time and cost, contain valuable information and experiences that have an important role in promoting the goal or goals of the organization. therefore, medical records filing can be called memory of the organizations which weakness in it’s performance will lead to damage in all hospital activities. The present research was done to survey the medical records filing in Khorramabad teaching hospitals affiliated to Lorestan university of medical sciences in 2009. Materials and Methods: This research is a cross-sectional descriptive-analytic study. Data was collected using check-lists and questionnaires based on medical filing unit standards, and by observation and interview. Completed check-lists were analyzed using analysis limit and grading method by SPSS software. Questionnaire was utilized for qualitative evaluation of medical filing unit to analyze and clarify the medical filing situation with all the details in each hospital. Results: The desirability degree of physical location and space, staff, medical records storage and retrieval system, equipment, procedures and guidelines and mechanized system of medical filing unit in the foresaid hospitals with 41% overall score percentage was “average”, and the highest percentage of compliance with the standard system belonged to mechanized system (48/8%), while the lowest one ( 26%) was related to physical location and space. Conclusion: The condition of the medical filing unit in all the studied hospitals were not ideal altogether. Therefore, the use of storage and retrieval modern technologies of medical record, such as establishing electronic medical filing, scanning and digital storing of medical records with fast retrieval capability cause result in Improvement in efficiency and performance of this important unit, optimum use of resources, cost saving and enhancement of patient care.

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Research is an active and well-organized procedure to discover, explain and review phenomena, events and hypotheses. The first step to organize matter of research in society is the find of a proper perception of existent abilities and facilities, as well as finding out weaknesses and strengths in research, so the present study was carried out to determine barriers to research from viewpoint of faculty members of Lorestan university of medical sciences. Materials and Methods: This cross-sectional study was carried out to determine barriers to research from viewpoint of faculty members of Lorestan university of medical sciences in 2008. All faculty members were our subjects. Data gathering tool was a four-part questionnaire, approved by valid scientific sources, designed based on Likert scale. Questionnaires were distributed among faculty members and at most the data of 93 questionnaires were analyzed by use of independent t-tests and variance analysis. Results: concerning the personal barriers shortage of time because of excessive teaching (32. 2%) and social and executive responsibilities (21. 4%) were the most, and lack of personal interest in research (60. 7%) and having no skill and mastery in scientific paper and proposal writing (50. 6%) were generally the least personal barriers. But about organizational barriers severity to approve research projects by the research meeting, administrative restrictive regulations (49. 2%), long procedure for a research proposal to be cheared by the related committee and deficiency of research privileges for the researchers’ promotion (39. 1%) were the most organizational barriers, and difficulties of results statistical deduction, ethical limitations (34. 9%) and compulsion for researchers to use a special framework and method (27. 9%) were among the least organizational barriers. Meanwhile no significant difference observed between mean score of personal barriers among faculties while there was a significant difference between mean score of organizational barriers. Conclusion: Regarding the essential role of knowledge and research, which are among the most important features of look on future, governments, organizations and nations should have more and better perception of change and future, because we will live and work in a future which is quite different from today. Thus to reach a productive research future, it seems necessary to remove above mentioned barriers.

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Many hospitalized children are suffered from medical errors that may cause serious injuries. The aim of this study was to evaluate medical errors in hospitalized children in khorramabad Madani hospital in the first half of 2008. Materials and Methods: This study was a cross sectional that was performed for all medical errors in hospitalized children in khorramabad Madani hospital from 21/3/2008 to 21/9/2008. The sampling method was census. Studied variables included: age, sex, weight, kinds of errers, education of parents, job of parents. Data was collected by questionnaire and analyzed by SPSS software. Results: In this study out of 2250 records, 151 (6/3%) had medical errors. 53%were girls and 47% were boys that there was a significant relation between sex and medical errors. 46/4%were related to age group lower than 2 years old. Most of the errors were occurred in weight group of 6kg. Types of medical errors included drug ordering 46/3% (involved incorrect dosage of drug (37%), frequency 28%, rout 19% and others 16%), transcribing10%, administering32/4%, dispensing11/3%. Most errors related to liquid therapy 76/2% and intravenous rout 85/4%. Most errors were occurred during night 47% and during weekend 56/6%. Conclusion: Medical errors are common in hospitalized patients, and in our study the rate of medical errors was 6/3%. So further efforts are needed to reduce them.

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The carried out studies show that psychological, emotive and social problems of students are important and need to serious and organized measures to select tutors. It is clear that lack of rendering suitable counseling prevents students from educational attainments. So with regard to importance and role of counseling, this research was carried out to determine the rate of students satisfaction from academic counseling of the tutors of Lorestan university of medical sciences. Materials and Methods: This descriptive cross-sectional study was carried out on 680 students including the third and forth term of all fields selected using census sampling. Data collection tool was a two part questionnaire (reliability = %79 ) which indicated students satisfaction in three levels. Then data were analyzed using statistical tests , X2 and SPSS software. Results: In this study 77. 9% of the students were female with age range of 19-35. The most reason for their referrals was educational problems (59. 2%). 37. 9% of the students had no satisfaction from the tutors, 44. 38% had moderate satisfaction and 17. 73% of them were satisfied with the tutors. Conclusion: Results indicated a weak level of satisfactory, so having positive, attitude towards academic counseling, it seems necessary to take action for implementing laws and regulations related to tutors, as well as evaluating their performances. Conducting codified educational programs for tutors can help achieving university high goals.

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Zona is caused by the reactivity of varicella zoster virus. The most prevalent effect of zona is Post Herpetic Neuralgia(PHN). PHN is a pain that can remain stably more than thirty days after skin losses. Despite the fact that there are different cures for PHN, none of them is certain. Some medications like capsaicin have herbal sources. Satureja khuzestanica is a plant which is indigenous to Lorestan and Khuzestan provinces and has proven effects on pain alleviation. This study investigated the effects of Satureja Khuzestanica essential oil on PHN. Material and methods: The study was carried out by clinical trails on fifty patients suffering from PHN. The patients were randomly divided into two groups. The experimental group received a solution containing the essential oil of Satureja khuzestanica with a five-percent density while the control group received the placebo. The pain intensities, before and after taking the medications, were recorded on a numerical scale. The results were analyzed using repeated- measures test, t-test, matched pairs t-test, and Mann-Whitney test. Result: The average pain intensities in the experimental group befor and after taking the essential oil were 8.12±1.48 and 5.72±2.9 respectively. On the other hand, the average pain intensities in the control group before and after taking the placebo were 7.8±1.57 and 8.04±1.46 respectively. In addition, the men´s reaction to the medication was meaningfully more noticeable than the women´s. Sixty percent of the patients experienced the alleviating effects of the drug. The side effects of the drug were observed in nine patients in the form of erythema and burning that vanished in an hour. There were no statistically significant differences regarding sex and age variables of the two groups. Conclusion: The essential oil of Satureja khuzestanicais effective on alleviating PHN. It is more efficient than other medications regarding the effect starting time, the stability of effect, the acceptance, and the side effects.

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Hypothyroidism is one of the problems that can cause severe growth and developmental defects in children and infants. By using anticonvulsive drugs (Phenobarbital, Carbamazepine, Navalproate , and Phenytoin), liver microsomal enzymes will be increased and will lead to hypothyroidism in infants because of increasing metabolism of T3, and T4 by liver. The purpose of this study was to evaluate the prevalence of hypothyroidism in children referring to the clinic of Shahid Madani hospital in Khrorramabad with anticonvulsive drug treatment during Fall, 2008, and Winter, 2009. Materials and Methods: In this study, the samples were collected from the children referring to the clinic of Shahid Madani hospital in Fall, 2008, and Winter, 2009. The patients were taking anticonvulsive drugs and had the acceptance criteria including the age range of 3 months to 13 years old, using anticonvulsive drugs at least for 2 months, having abnormal EEG, etc. The data gathering instrument was a questionnaire containing the demographic information including age, gender, type of drug, duration of using drugs, etc. The lab data (T3UR, T4, and TSH) were analyzed after they were collected. Results: Among 38 referring epileptic children taking anticonvulsive drugs, 4 (10.5%) patients had hypothyroid so that 2 (5.25%) of them were clinical hypothyroid, and 2 (5.25%) were subclinical hypothyroid. Moreover, 2 out of the 4 patients(50%) were girls and 2 (50%) were boys, and the mean age was 6.5 2 years with the median of 6.5 years. Conclusion: The prevalence of hypothyroidism in patients with anticonvulsive drugs treatment in the clinic of Shahid Madani hospital during Fall, 2008, and Winter, 2009 was 10.5%. So, there was no significant relationship between age and gender. A significant relationship was found between duration of using anticonvulsive drugs and hypothyroidism in children.

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Diabetic nephropathy is the common cause of leading to end stage of renal disease.Satureja Khozestanica essence for the first time used as antioxidant, antidiabetic and anti-inflammatory agent for inhibition of diabetic nephropathy. Materials and Methods: 40 male rats were uninephrectomized from left flank .The rats were divided into four groups randomly(ten per each group), group one as control, group two diabetic without treatment and groups three and four, treatment with Satureja essence with 250 ppm or 500 ppm in drinking water respectively. Diabetes was induced in the second, third and fourth groups by alloxan injection subcutaneously .After 8 weeks treatment of serum malondialdehyde was measured. Kidney paraffin sections were prepared and stained by Periodic Acid Schiff method.Glomerular volume ,intraglomerular mesangial volume and volume of glomerular capillary were estimated by stereological rules. Data were compared by SPSS13 software and Mann Whitney nonparametric test at p<0.05. Results: Glomerular hypertrophy, mesangial expansion and reduce of glomerular capillary volume in the groups that treated by Satureja essence, significantly were inhibited in comparisor with diabetic untreated group but it cannot be saved at level of control group significantly(p<0.05). The level of serum malondialdehyde in treated groups was maintained at the level of control group significantly (p<0.05). Conclusion: Satureja Khozestanica essence significantly can inhibit glomerular hypertrophy, mesangial expansion and save glomerullar capillary volume in diabetic rats significantly.

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Mastitis is one of the most common inflammatory conditions of breast that may occur in 10% of the breastfeeding mothers. This complication can cause chemical and physical changes in breast milk and may lead to the discontinuation of breastfeeding and weight loss and growth retardation of infant. This study aims at determination of clinical and subclinical mastitis based on chemical and physical changes in breast milk . Materials and Methods: In this cross sectional study , 229 breastfeeding mothers from clinics of Khorramabad were selected using a random-clustring method and sample of their breast milk were collected.Data gathered by a questionnaire.The data were analyzed using SPSS software. Statistical analysis was done utilizing Chi-square, Mann-Whitney test, and T-test. The p value was <0.05, therefore  it was considered to be significant . Results: The results of the study, indicated that mastitis was observed in 13 (5.7% ) of the studied lactating women. The bacteriological culture results were 12 (99.6%) out of 13 positive samples growth of coagulase negative Staphylococci and 1 sample (0.4%) growth of E.Coli. There was a statistically significant difference in the median of breast milk's lactose, protein, pH, and density between two groups ( P< 0.001). Coclusion : These results indicate that mastitis has effect on chemical and physical properties of breast milk is effective, so that the fat, protein, lactose and also pH, density , freezing point of milk in mothers who have mastitis is less in comparision with healthy mothers without mastitis .

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Rice is the main food of people in Iran and about 2.4 billion of the world population. Although its cultivation areas are less than wheat but 85% of the total product is used by people. Consumption of rice per person is estimated 42.5 kg in Iran. So it is the second high consumed agricultural product. The aim of this study was determination amount of toxic and heavy metals in high consumed rice varites cultivated in different areas of Lorestan province. Materials and Methods: In this study 99 rice samples (Tarem and Domsiah) cultivated in three areas of Lorestan( khorramabad, Dorud and Borujerd) province were collected. Amount of Lead and Cadmium were analyzed by atomic absorption model BRAIC WFX 130. Data were gathered and analyzed by SPSS software and compared with national standards. Results: The results for Cd and Pb were 0.037±0.06 and 0.077±0.08 mg/kg respectively. Conclusion: Cadmium and Lead levels in rice samples caltivated in Lorestan province were less than Permissible limit, so there is no risk for human health.

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Admission department controls the input and output of the system in any healthcare organization and using some management techniques such as process analysis plays an important role in identifying problems of this unit. The present research was done to study the inpatient admission unit condition in Khorramabad teaching hospitals affiliated to Lorestan university of medical sciences in 2009. Materials and Methods: This research is a descriptive cross-sectional study. Data were collected using researcher made check-lists based on inpatient admission department standards, and by observation and interview with process owners. The validity and reliability of the checklists were evaluated by content validity and test-retest respectively. The inpatient admission unit process analysis was also done in all the above-mentioned hospitals and data were analyzed by analysis limit, descriptive statistic indices, and SPSS software. The collected information was prepared as statistical tables. Results: The inpatient admission unit process was similar in foresaid hospitals and only the cash desk, among the units involving in this process was locally centeralized. Mean of waiting time for inpatient admission was 19/10±20/50 minutes.The desirability degree of physical facilities, space, staff, task process approaches, policies, equipment and mechanized system of inpatient admission department in the foresaid hospitals with 35.5% score percentage was average, and the highest percentage correspondence with standard belonged to equipment condition (43.3%) , while the lowest one ( 30%) related to physical facilities and space. Conclusion: The condition of the investigated admission departments was evaluated as average. To improve admission process, some solutions should be taken into consideration including: preparing and supplying special strategies of inpatient admission department, employing professional and interested staff, holding postgraduation courses, ideal allotting of resources and space, regular evaluation of the admission department function and implementing process improvement procedures.

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Hallux valgus or laterally deviation of thebig toe to the out side is a complex disease. If there is not any treatment it will cause deviation of other toes. Hallux valgus is 3 times more common in females that may cause uncomfortable deformity of foot , problem with wearing unsuitable and narrow-toed box shoes and pain on the inside of the big toe over the metatarsal joint , therefore patients may refer to physician. Untreated Hallux valgus may cause hamer toe deformity of the second toe. Materials and Methods: This study was a cohort study carried out on the patients referred to orthopedic clinic of Ashayer hospital with complaint of Hallux valgus. Two groups of 30cases were ramdomly selected and then the splints designed by us were given to case group and Night splint and interdigital pad were given to the control group. The patients were followed for one year as every three months and in every time weight bearing antroposterior radiography of both foot were taken and Hallux valgus and inter metatarsal angles were measured, and data were analyzed using SPSS and repeated measure test. Results: In the patients who used our splints regularly Hallux valgus angles decresed more considerably than those who used splints available on the market ( p<0.001). Conclusion: This study showed that despite the contraversies in nonoperative treatment of Hallux valgus, if the Hallux valgus angle of patients are mild to moderate, this splints can be used to treat it.

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Background : Drug abuse and addiction is a social and medical burden which has drastic consequences in the community. There has been various rehabilitative and healing programs for the addicts.The conducted studies have shown that therapeutic community treatment model is an appropriate method for restoring the addicts to society. The present study tries to evaluate the impact of TC treatment programs on the addicts’ personality characteristics. Materials and Methods: This interventional study includes all the male addicts for whom the detoxification period has been finished. The subjects were selected using easy random sampling method form clients referred to TC center. At the beginning of the study , SCL90 questionnaire was filled out by psychologist for each sample, then 60 cases were selected based on the sample size formula. The subjects participated in a training TC program for three months daily except weekends. At the end of a three-month program, SCL 90 was given to the subjects to be completed and the data were gathered and analyzed. Results: The results showed that the subjects before entering the study were: 16.7% normal ,40% border personality disorder ,30% sick and 13.4% very sick. After intervention of TC ,25% normal ,66.7% with suspicious,8.3% sick. None of the cases were highly sick after the TC intervention.The mean of the marks for personality disorders before the TC intervention was 2.4± 0.92,after the intervention it was 1.83 ± 0.56.The Willcoxson rating test showed a significant difference between the severity of personality disorders before and after the TC intervention(p<0.001). Conclusion: As it was mentioned in the findings, the implementation of TC intervention had a significant effect on the scores obtained for personality disorder. So administrators and policy makers who are responsible for addiction control are recommended to develop and support the centers for Therapeutic Community and endeavour to provide a life without narcotic substances.

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Background: The age pyramid of our country is being reversed. Planning for the provision of healthcare services for the elderly requires the investigation of the factors affecting their utilization of health services. The aim of this study was to determine the availability of hearth services for the elderly at Lorestan province and the relationship between their utilization of these services with socioeconomic variables.
Materials and Methods:  This cross-sectional study was conducted in 2017. The study population included the elderly discharged from the hospitals affiliated to Lorestan University of Medical Sciences in 2017. The data of 428 patients were collected during phone interviews. The collected data were analysed by SPSS-18 software and chi-square test, Mann-Whitney test, Spearman test, and independent t-test.
Results: The rates of the utilization of medical and paramedical services in at least one occasion during the last three months among the studied elderly were 25.5% and 27.7%, respectivly. Utilization of health services was significantly affected by family structure, literacy status, residence of the patient (town or village), social origin (the residence until the age of 18), unemployment status, number of children, type of insurance, complementary insurance, having a chronic desease, self-evaluation of health status, satisfaction of the status quo, income, employment status, house ownership, and having a private room. However, there were not significant relationships between the elderly’s utilization of different health services and their gender, marital status, children’s location, and car ownership.
Conclusion: Elderly people utilize different health services more than the general population. Considering the significant relationship between certain socioeconomic variables and the utilization of health services among the elderly, it is recommended that planning for the provision of health services to them should be based on the investigation of their utilization of health services and their determinants.

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