Yafteh

Chronic appendicitis in a patient with 15 years abdominal pain Khorasani B1, Gholizadeh Pasha A2 1. Assistant professor, Department of surgery, Faculty of medicine, Tehran University of rehabilitation 2. Assistant professor, Department of surgery, Faculty of medicine, Babol University of medical sciences Abstract Background: Acute appendicitis is a completely known disease but for many physicians chronic appendicitis is unknown and some of them don't believe in it. Although the number of people suffer from chronic appendicitis is much fewer than those who suffer from acute appendicitis, we shouldn't ignore it. Clinical symptoms for these patients are chronic, longtime and recurrent abdominal pain, which is usually in the right lower quadrant of the abdomen. In the Para clinical examinations there isn't any considerable pathological problem (in urine, stool, and sonography of the abdomen and pelvis.) By recognizing appendicitis and appendectomy, the symptoms will be vanished and the patients will recover. Case presentation: The case was a 57-year-old man who has complained from chronic abdominal pain in the RLQ area since 15years ago. No pathological problem had been found in all diagnostic process. Conclusion: The problem was diagnosed as the chronic appendicitis and he underwent the appendectomy by laparoscopic procedure and was completely recovered. Key words: Chronic Appendicitis, Abdominal pain

Risks from ionizing radiation during pregnancy Gholami M1, Abedini MR2, Khossravi HR3, Akbari S4 1. Instructor, Department of medical physics, Faculty of medicine, Lorestan University of medical sciences 2. Assistant professor, Department of radiology, Faculty of medicine, Lorestan University of medical sciences 3. Assistant professor, Department of radiation protection, Iranian Atomic Energy Organization 4. Assistant professor, Department of gynecology, Faculty of medicine, Lorestan University of medical sciences Abstract Background: The discovery of the X-ray in November 1895 by the W. C. Roentgen caused the increasing use of x-ray, because of the benefits that patients get from the resultant the diagnosis. Since medical radiation exposure are mainly in artificial radiation sources, immediately after the x- ray discovery, progressive dermatitis and ophthalmic diseases were occurred in the early physicians and physicists. But delay effects were observed approximately 20 years after the x-ray discovery. History: Based on the studies, ionizing radiation is a potential hazard to the developing fetus, avoiding unnecessary radiation exposure to pregnant women is a standard practice in radiology, unless there are important clinical indications. Due to difference in stages of fetus development, using of the current radiation protection standards includes: justification of a practice, optimization of radiation protection procedures and dose limitation to prevent of serious radiation induced conditions is necessary. Conclusion: Conversely the somatic and genetic effects of x-rays, since the X-ray has the benefit effects, special in diagnostic and treatment procedures, there is increasing use of x-ray, so using of the latest radiation protection procedures is necessary. Radiation protection not only is a scientific subject but also is a philosophy, Moral and reasonable. since the ionizing radiation is a potential hazard to the developing fetus, avoiding unnecessary radiation exposure to the pregnant women is recommended, unless in important clinical conditions. Key words: Diagnostic radiology, fetal dose, Pregnancy

Comparison of failure rates of CU t 380 A and CU safe 300 IUDs four years after insertion Changavi F1, janani F1, Asti P1, Akbari S2 1. Instructor, Department of midwifery, Faculty of nursing and midwifery, Lorestan University of Medical Sciences 2. Instructor, Department of gynecology, Faculty of medicine, Lorestan University of Medical Sciences Abstract Background: IUD is a useful and effective tool for family planning. Different kinds of this equipment are available at the market, but currently the most commonly used one in our country is CU T380A. Previous studies have shown that CU safe 300 is more effective and associated with less complications than CU t380A, thus it is more acceptable by users. The aim of this study was to determine and compare failure rate of CU T380A and CU safe 300 IUDS, four years after insertion. Materials and methods: The present research is a cohort study carried out on 246 women who referred to health clinics of Khorramabad four years ago. These women divided into two equal groups. One group used CU T380A and the other group used CU safe 300. The rate of unwanted delayed complications such as spontaneous bleeding, pregnancy and spontaneous repelling of the IUDs were assessed by a questionnaire. Data were analyzed by Chi square and paired T test. Results: Failure rate of CU T380A was more than CU safe 300. Statistical tests showed significant differences between these two groups. Conclusion: This study shows that new IUD (CU safe 300 ) which are smaller in size have less Failure rate and more acceptable by women, so their use is suggested in health clinics. Key words: CU T380A, CU safe 300, IUD failure rate.

Comparison of the effect of broncodiatory albotrol from spacer and nebulazor foe freatment of Astma patients Tavana S1, Nadi E1, Ansari M2, zeraati F3, Hashemi H1, Mani Kashani Kh4, Mavallat M5 1. Assistant professor, Department of internal, Faculty of medicine, Hamedan University of medical sciences 2. Associate professor, Department of internal, Faculty of medicine, Hamedan University of medical sciences 3. Associate professor, Department of Pharmacology, Faculty of medicine, Hamedan University of medical sciences 4. Instructor, Department of social medicine, Faculty of medicine, Hamedan University of medical sciences 5. General practitioner, Tuberculosis and lung research group, Faculty of medicine, Hamedan University of medical sciences Abstract Background: Asthma is an inflammatory and chronic disorder of trachobronchial tree that is associated with increased response to allergens. Treatment of acute attack of asthma is short acting 2 agonist such as Albuterol that is used via a nebulizer or Metered-dose inhaler (MDI) with and attached spacer. Object of this study was evaluation of therapeutic effects of Albuterol via a nebulizer or MDI with an attached holding chamber in patients that had been referred to Emergency departement of Mobasher Hospital in Hamadan. Materials and methods: The present study was a clinical trial (before and after) in 60 patients that were suffered from acute attack asthma. Inclusion criterias were 16-65 years old age patients, FEV1, below 60% of predicted value, and cooperation for spirometry performance. Exclusion criterias were COPD, cardiovascular disorders, pneumonia, preumothorex, or their systemic or pulmonary disorders,severe respiratory failure with cyanosis or confusion, pregnancy and smoking. On arrival to the ED, all patients underwent spirometery and all of patients received oxygen and a single dose of 8 mg intravenous dexamethasone. Immediately thereafter patients were randomized to two groups.The study was designed as double blind trial. The first group patients received four puffs Albuterol attached to spacer and immediately distilled water via nebulizer. The second group patientts received 5 mg Albuterol solution via nebulizer after administration of placebo inhaler attached to holding chamber. All of the patients received a total of four treatment. The first dose was administered immediately after spirometry and then every 30 minutes. Spirometry was performed at entry between to the study and then 15 minutes after each treatment. Results: Analysis of comparison of bronchodilating effects of salbutamol via nebulizer or MDI with attached to spacer showed similar effects in two methods (P>0.05). FEV1, FVC, FEV1/FVC changes were significant among four treatments in every group (P<0.05) but there was no difference between two methods among four treatments (P<0.05). Conclusion: A short acting 2-agonist such as Albuterol can be administer in patients with acute attack asthma with every two methods (nebulizer or MDI with attached spacer) and have similar bronchodilating effect. Key words: Asthma, Albuterol, Salbutamol

The association of hemianesthesia, hemineglect and hemianopsia with disability score Ghandhari K1, Eizadi Mavad Z2 1. Associate professor, Department of neuroscience, Faculty of medicine, Mashhad University of medical sciences 2. General practitioner, Valieasr Hospital, Birjand Abstract Background: Recognition of Clinical factors associated with disability of stroke patients is important, because they can affect the prognosis and future recovery following rehabilitation. Materials and methods: Consecutive stroke patients admitted in Valie-Asr hospital of Khorasan enrolled in a prospective study in 2005. Hemihyposthesia, hemianesthesia, hemineglect and homonymous hemianopsia were evaluated in the patients. Disability score was determined based on the Rankin scale at 72 hours post stroke. Mean of Rankin Disability Score (MRDS) was analysed by T and Fisher tests and p<0.05 regarded as significant. Results: 329 stroke patients were investigated. Hemihyposthesia, hemianesthesia, hemineglect and homonymous hemianopsia were found in 37.4%, 13.8%, 7.9% and 7.3% respectively. MRDS was significantly higher in patients with hemianesthesia than other stroke patients, p<0.001. MRDS of patients with each of hemihypoestheisa, hemineglect and homonyous hemianopsia was not significantly different than patients without these abnormalities, p=0.44, p=023 and p=0.83 respectively. Patients with triad of hemianesthesia, hemineglect and homonymous hemianopsia had significantly higher MRDS than others, p<0.001. Conclusion: Hemianesthesia is the most important clinical causative factor of MRDS of the stroke patients. Presence of above triad predicts the highest MRDS in these patients. Key words: Hemihyposthesia, Hemianesthesia, Hemineglect, Homonymous hemianopsia, Disability score, Stroke

The survey of the psychological and personality characteristics of delinquent girls and women running away from home Saki M1, Safa M2, Jazayeri H3, Asti P4, Jariani M2, Saki M5 1. Instructor, Department of psychology, Faculty of nursing and midwifery, Lorestan University of medical sciences 2. Assistant professor, Department of psychology, Faculty of medicine, Lorestan University of medical sciences 3. Master of science, psychology 4. Instructor, Department of midwifery, Faculty of nursing and midwifery, Lorestan University of medical sciences 5. Instructor, Department of pediatrics, Faculty of health, Lorestan University of medical sciences Abstract Background: Family environment is the first place in which child may recognize his potentialities and talents and tries to raise those potentialities. If family fails to provide the child with an appropriate situation to grow and evolve his character, he may develop the basis of social delinquencies.All kinds of crimes may form in the family. Studies show family as a social factor and character as an inner factor can create the grounds for the criminal behavior. The present study tries to investigate the psychological and personality factors learning people to run away from their homes. Materials and methods: The present survey is a descriptive- analytical study. The cases were selected by census method. All the women and girls who were kept in the intervening centers were studied during one year. A two-section questionnaire containing demographic, family characteristics as well as the standard questionnaire named SCL 90 were used for data collection. The questionnaire was completed using clinical interview. The data was analyzed using SPSS software. Results: Among 73 cases participated in the study, 37.5% was under 20 years, 91.7% was housewife and 58.3% had elementary education, 58 % was of those who migrated from villages to towns. Most of them were among the mid born of the families. 36% had imprisonment, 30.6% had substance abuse, and 63.9% was among those who had previous crime records. 46.3% of the married ones mentioned compulsory marriage as the cause of leaving their homes. 41.7% had a bad economic situation. 25% of the children were criminal. 54.2% had challenges and disputes with parents which they mentioned this as the cause of leaving their homes. 46.3% of the participants had Phobia, 64.3% had psychotism, 83.5% had hypochondriasis, 90.4% had obsessive compulsive, and 82.8% had depression, 84.9 % anxiety, 68.6% was aggressive, 41% paranoid and 56.2% had supportive problems. Conclusion: There is a significant relationship between leaving homes and variables such as challenges with parents, compulsory marriages, parents’ education and unemployment. Also there is a significant relationship between personal and emotional characteristics and running away from home. Key words: Delinquency, Running away from home

The screening of depressive disorder in 20- 64 aged people in Khorramabad Nazari H1, Namdari P2, Tarrahi MJ3, Badrizadeh A4 1. Assistant professor, Department of psychology, Faculty of medicine, Lorestan University of medical sciences 2. Instructor, Department of social medicine, Faculty of health, Lorestan University of Medical Sciences 3. Instructor, Department of Epidemiology, Lorestan University of Medical Sciences 4. Bachelor of science, Nursing, Lorestan University of Medical Sciences Abstract Background: Depressive disorder is one of the most prevalent mental disorders and causes disability and early death. This disorder leads to increased economic burden for people and society. Mental disorders are the cause of 15 percent of disability and early death in developing countries. According to the joint report of W.H.O and the word Bank, depressive disorder is the first one among the ten most important causes of disability and disablement all over the world. Thus the diagnosis and treatment of this abnormality is very important for patients, families and society. Materials and methods: The aim of this cross–sectional study was to screen the depressive disorder in people aged 20-64 in Khorramabad city. Data were collected by Beck Depression Questionnaire that detects depression. Khorramabad city has tow region and each region has three areas. The sample (2740 persons) was selected from all areas by a clustered and systematic sampling method. Data were analyzed by statistical software. Results: 33.4 percent had symptoms of depression. 25% of the affected patients had minor depression, 7.4% had moderate and 1% had sever depression. The prevalence of depression was highest in age group 50-64 years and lowest in age group 30-46 years. Depression was higher in women (34.3%) than men (32.4%). The highest rate of depression was in widowed (43.3%) and the lowest rate of prevalence was in married (29%). The rate of depression in non-specialists workers was higher (43.2%) than officers (16.2). The rate of depression in primary school and diploma person (17.4%) was higher than less educated or illiterates (7.1%) and university educated (8.6%) people. The lowest prevalence of depression was in persons with more than two million Rials salary (3.5%) and highest prevalence of depression was in persons with salary lower than two million Rials. the prevalence of depression was related to factors including age, marital status, educational status, occupation, family, salary and house status (p<0/001). But, there were not statistically significant related to sex, geographic area. Conclusion: Mental health is usually neglected but, its prevalence and disability is not lower than infectious diseases according to the physician’s experiences and epidemiologic studies. Thus, appropriate diagnosis, management and treatment of it is very important for patinas, family and society and decreases economic and mental problems. Key words: Depression, Screening, Prevalence

Situation of safety and protection of personnel’s in diagnostic laboratories in relation to radioactive Iodine Mehrdad R1, Hosseini AR2 1. Assistant professor, Department of occupational medicine, Faculty of medicine, Tehran University of medical sciences 2. Resident, Department of occupational medicine, Faculty of medicine, Tehran University of medical sciences Abstract Background: Iodin (I) 125 is one of the radioactive materials that is used in medical laboratories for hormonal evaluation in radioimmunoassay (RIA) method. In many laboratories sume of personnel are exposed to I125. When one of the staff is exposed to I125, especially internal exposure, there is concern about ionizing radiation effects. Therefore preventive measures against these hazards are required. Materials and methods: The present study was carried out in 13 medical laboratories in Qazvin city and 51 employees in autumn 2004.We used a safety checklist that filled by researcher at the field of laboratory.Fitness for work (FFW) assessment was done through paraclinic history (CBC, TSH); familial history of malignancy (first and secoundry family) and eventually physical examination. Results: From all personel 82% used appropriate gloves and 61% avoided drinking, eating, smoking and cosmetic use in work place. 90% decontaminated working surfaces immediately and 94% washed hands at the end of tests. All of them were exposed to open vials that can potentially generate aerosols. Absorbent coverages on working surfaces were used only by 2% of employees and 54% used appropriate local ventilation (hood). Preemployment examinations (for FFW) and periodic medical surveillance weren't done at all. Conclusion: In the laboratories which we studied personnel protective measures was better than administrative controls, and it is expected that the conditions will be better by training of personnel and managers, and seriously auditing laboratories. Key words: I125, safety, clinical lab, Occupational health, radioactivity

The effect of menstrual cycle phase on the meperidine and metoclopramide consumption rate for controlling postoperative pain, nausea and vomiting Vahabi S1, Ghafarzade M2, Lorzade N2, Moradkhani MR1, Frazan B1, Geranghadr P3 1. Assistant professor, Department of anesthesiology, Faculty of medicine, Lorestan University of medical sciences 2. Assistant professor, Department of gynecology, Faculty of medicine, Lorestan University of medical sciences 3. General practitioner Abstract Background: Postoperative nausea, vomiting (PONV) and pain are common causes of postoperative morbidity. Menstrual cycle may be one of the several factors that influence the incidence of them. This study was done to evaluate the effect of menstrual cycle phase on the on the Meperidine and Metoclopramide consumption rate for controlling postoperative pain, nausea and vomiting. Materials and methods: On the basis of the menstrual cycle {pre ± menstrual (PD 25-6) follicular phase (PD 8-12) ovulatory phase (PD 13-15) and luteal (PD 20-24)}, 63 patients enrolled in this blinded, prospective study. All patients underwent a standardized surgery. Meperidine 1mg/kg was given to patients who had pain intensity more than 5 on Visual Analog Scale (VAS) intravascularly in recovery, and intramuscularly in the ward. Metoclopramide 0.3mg/kg was administered intravascularly to patients who had vomiting. A blinded person recorded PONV and pain score as well as required amount of Meperidine and Metoclopramide in the recovery and ward arrival time, 6, 12, 18 and 24 hours postoperatively. Results: At the first 24 h post gynecological operation, PONV score was higher in luteal and follicular phase and lowest in pre ± menstrual phase (P< 0.001, X²= 41.64). The need for Metoclopramide in luteal phase was more than other phases (P < 0.001, X² =32.9). The highest pain score was in luteal phase (P< 0.001, X² =4.6) and the required dose of Meperidine was higher in luteal and follicular phase (P< 0.001, X² = 22.2). Conclusion: We suggest that scheduling of surgery according to the menstrual phase may reduce the incidence of PONV and postoperative pain intensity as well as the required dose of Meperidine and Metoclopramide and hospitalization costs. Key words: PONV, pain score, menstrual cycle phase, Meperidine, Metoclopramide.

The knowledge of Tehran citizens on environmental pollutions, related health effects and their information sources Mesdaghinia A1, Yunesian M2, Naseri S1, Jafari A3, Moradi A4, Farahdoust F5, Yaghoubi L6 1. Professor, Department of environmental health, Faculty of public health and institute of health research, Tehran University of medical sciences 2. Assistant professor, Department of environmental health, Faculty of public health and institute of health research, Tehran University of medical sciences 3. Instructor, Department of environmental health, Faculty of health, Lorestan University of medical sciences 4. Master of science, Epidemiology, Hamadan University of medical sciences 5. Master of science, Social researches 6. Bachelor of science, Environmental health Abstract Background: Environmental exposures usually occur to chemical, physical and microbiological factors. WHO has evaluated related loading of 25 risk factors that 7 of these are environmental factors. With regard to the lack of comprehensive studies, this survey was carried out in Tehran to investigate the knowledge of the citizens on environmental pollutions, related health effects and their information sources. Materials and methods: Present survey was carried out on 1596 individual upper than 18 years old. Samples were taken randomly. Data was collected by phone interview. In order to determine correlation between qualitative variables, Chi -square test was used. In necessary condition OR index was used. Reliability of questions in any part was tested by principal component analysis. Results: Results of this survey showed that in general 54.2% of people have a good knowledge about environmental pollution and health effects. The knowledge of women, youths (18 - 20years old), university educated people (PhD), westerns and northern, and those who had got their information from radio / TV is more than others. The knowledge of people about the environmental pollution and their health effects with education level and source of information had a significant difference. After elimination the effect of variables that probably interfere with knowledge of people, logistic regression was done. In this case, there was a correlation between education level and information sources. More than 80% of people got their information from radio and TV. Newspaper and social conversation were the next important sources, respectively. Conclusion: Although Tehran citizen knowledge about some environmental problems and related institutions was low, in general, Tehran citizen's knowledge about the problem and special health issues resulted from air pollution was good. With regard to importance of environmental factors in public health because of machinery life especially in large cities of our country, more research should be accomplished to identify and how to control them. Key words: Environmental pollutions, knowledge, Information Sources.

A Case of Bardet-Biedl Syndrome Etemadi K1, Khazaii MR2 1. MSC of Human Genetic, Molecular Medicine and Genetic department, Medical school, Hamadan University of medical sciences. 2. Assistant professor of Pediatric Urology Abstract Background: The Bardet Biedl syndrome is a heterogenous and autosomal recessive disorder. Primary features are: retinitis pigmentosa, obesity, polydactyly, mental retardation, renal abnormalities and hypogonadism. Renal failure is the major cause of death in homozygote patients, with chronic glomerolopathy that cause chronic renal disease. Secondary features are: speech disorder delay, developmental delay, polyuria, diabetes mellitus and hypertension. The diagnosis of Bardet- Biedl syndrome is established by clinical findings. Twelve genes are known to be associated with Bardet Biedl syndromes: BBS1, BBS2… BBS12. Case presentation: In this article we report a four and half year old boy that have Bardet Biedl syndrome as a result of a consanguine marriage (third degree). Conclusion: A monogenic syndrome such as Bardet Biedl has a lot of symptoms. These symptoms are out put of a mutation in locus of a recessive allel. Therefore people like to marry consanguinly have to do genetic counseling before marriage. Because analysis of family history will reduced the risk of such syndromes. Key words: Bardet Biedl Syndrome

Pediatric Idiopathic Pulmonary Fibrosis: A Case Series report Khalilzadeh S1, Baghaei N2, Bolorsaz MR1, Masjedi MR3 1. Associate professor, Department of pediatrics, Education, research and treatment center of tuberculosis and long diseases, Shahid Beheshti University of medical sciences 2. Assistant professor, Department of pediatrics, Education, research and treatment center of tuberculosis and long diseases, Shahid Beheshti University of medical sciences 3. professor, Department of internal, Education, research and treatment center of tuberculosis and long diseases, Shahid Beheshti University of medical sciences Abstract Background: Idiopathic Pulmonary Fibrosis (IPF) is a chronic rare disease with unknown etiology which is usually fatal and occurs mostly in adults. This disease is extremely rare in children and infants. Case presentation: Eight children with IPF who were examined in the pediatric department of Masih Daneshvari Hospital during 2001-2004 have been reported. There were 5 boys and 3 girls at the age range of 7 to 13 years (mean age 10.2 yrs). Clinical symptoms were cough and dyspnea in all patients which were progressive and exacerbated by recurrent respiratory infections. In clinical examination, crackles were found in both lungs of all patients while cyanosis and clubbing were detected in 5 subjects. Chest x ray showed reticulonodular and bullocystic patterns in 6 and 2 cases respectively. Pulmonary function tests in all patients were in concord with those of pulmonary restrictive diseases. To make a definite diagnosis, lung biopsy was performed in all patients which showed histologic changes in accord with IPF. Patients were mostly treated with steroids. In the present study, the prognosis of disease has been good in our patients and only one death occurred due to respiratory failure. Conclusion: To our knowledge, this study is the first report of P.I.P.F (Pediatric Idiopathic Pulmonary Fibrosis) in Iran. Other cases of this disease may be found in other medical centers which should be collected and evaluated by the researchers. Key words: Idiopathic pulmonary fibrosis, Children, PIPF

The effect of music on post operative delirium in elder women undergoing hip surgery hospitalized in orthopaedic ward Beiranvand A1, Fallahi M2, Ashayeri H3, Rahgozar M4 1. Instructor, Department of nursing, Faculty of nursing, Lorestan University of medical sciences 2. Assistant professor, Department of nursing, Faculty of nursing, Iran University of medical sciences 3. Associate professor, Department of psychology medicine, Faculty of medicine, Iran University of medical sciences 4. Assistant professor, Department of statistic, Faculty of medicine, Iran University of medical sciences Abstract Background: Usually the incidence rate of delirium after hip surgery in elders is high. It causes several complication,bad prognosis and even mortality. Due to several side effects of drugs, music can be a nonpharmacological unrisk method for prevention of delirium. The purpose of the present study was to determin the effect of music on post operative delirium in elder women who underwent hip surgery hospitalized in orthopaedic ward. Materials and methods: The present study is a semi experimental research. The samples were including 100 old women over 65 years of age with hip fracture in khorramabad Shohada hospital during 4 month. They were allocated according to inclusion criteria and sampling method to 2 equal groups of intervention and control, each with 50 persons. The tools of gathering data were demographic questionnaire, screening questionnaire and mini-mental state examination(MMSE). First, patient`s cognitive state were assessed by MMSE. Music was played for persons in intervention group for 20 minute, three times daily from 1 day before surgery until 4 days after surgery,while participants in the control group received standard care. During the intervention ,patient`s cognitive state was assessed by MMSE two times daily. Then patient`s were divided in 2 groups before and after scores in intervention group were compared. Results: Findings showed that there is significant difference between before and after scores in intervention group(p=0/018). This difference even was significant with modification of before cognitive scores (p<0.001) and age (p<0.001)of intervention group. Conclusion: This study provides evidence that music listening is an effective and unrisk tool for prevention of post hip surgical delirium in elders. Key words: music,delirium,hip surgery,elderly

The Effects of High-Risk-Behavior Prevetion Educational Program on the Knowledge and Atittude of School Health Trainers in Khoramabad in 1384 Malekshahi F1, Momen-nasab M1 1. Instructor, Department of nursing, Faculty of nursing and midwifery, Lorestan University of medical sciences Abstract Background: High risk behaviors are the most prevalent factors that endanger the health of a community. Nowadays the prevalence of high risk behaviors, especially among adolescents and young adults has created a lot of worries for human societies and despite the preventive measures of the last three decades, high risk behaviors have grown tremendousely in the world and have imposed heavy medical bills.Since prevention has been recognized to be the only way of controlling such behaviors, medical professionals should change people’s health behaviors by promoting the knowledge of the society. Among these professionals, health trainers can have an important role in increasing community knowledge for the prevention and control of high risk behaviors. Therefore, the level of their knowledge is important. This study was carried out to evaluate the effect of high-risk-behavior prevetion educational program on the knowledge and atittude of school health trainers in Khoramabad in 1384. Materials and methods: The study was a quasi-experimental one. The sample of the study was all school health trainers (n=50) in Khoramabad. The data collection tool was a three-section questionnaire including questions on demographic data, knowledge, and atittude toward high risk behaviors which was prepared based on reliable information, books and papers and was used after confirming its reliability and validity. In this study the intervening variable was the high-risk-behavior prevetion educational program. The educational method in this study was a two-session workshop. The educational content emphasized on the promotion of knowledge, positive attitude toward prevetion to implement healthy behaviors which was performed by university instructors in the field. After two months of education, the post test was performed on the sample. After collecting the data, the score of each question was obtained and the likert scale was used to obtain the sample’s level of knowledge and attitude. The level of knowledge was determined to be weak if their score was between 0 to 18, moderate in the range of 19-35, and good from 35 to 55. Then data was analyzed by statistical tests (t-test). Results: The results of the study showed that 78.7% of the sample had some information about high risk behaviors before education, and only 3.4% could define high risk behaviors correctly. The majority of the sample had received their information on high risk behaviors through variouse sources including radio, TV, books and other publications. Paired T-test statistic showed a significant difference (p=0/0001) between the pre and post experimental average score of the sample knowledge and atittude. Conclusion: The results of the study indicated that health education program has caused an increase in the knowledge and atittude of the sample.Therefore, regarding the trainers’ respansibility in the protection of cimmunity and children’s health, it is imperative to promote their knowledge through continued education on the control and prevention by including them in school books and formating a health consulting committee in schools. Key words: health education program, school health educator, high risk behaviors, prevention. atittude, knowledge

Prevalence of Intestinal Parasites in HIV+ and AIDS Patients Khorramabad 2006 Fallahi Sh1, Badparva E1, Nahrovanian H2, Chegeni Sharafi A3, Ebrahimzadeh F4 1. Instructor, Department of parasitology, Faculty of medicine, Lorestan University of medical sciences 2. PhD, Pasteur institute of Iran. 3. Master of science, parasitology 4. Instructor, Department of statistic, Faculty of health, Lorestan University of medical sciences Abstract Background: Intestinal parasites are the most common enteric pathogens in patients with HIV infection. These intestinal pathogens are the main cause of morbidity and mortality in HIV positive patients. There have been very few reports on the prevalence of intestinal parasites in HIV positive and AIDS patients in Iran. To investigate the prevalence of opportunistic intestinal parasites in this population, a cross-sectional study was carried out on 306 HIV positive and AIDS patients in Khorramabad city. Materials and methods: Demographic data were collected by a questionnaire. Three stool samples were collected from every patient. Direct smear, Formalin-ether concentration techniques and Modified acid fast (Kinione) and modified trichorome staining method carried out on all samples. Data was analyzed by T-test and Chi square method. Results: After examination’s it detect that, Prevalence of the intestinal parasite in HIV positive and AIDS patients in Khorramabad city was 22.5% and This rate was higher in AIDS patients. Moreover, we demonstrated that there is a significant relationship between age group, level of education, occupation, type of intestinal signs, variants and infection to intestinal parasites. It’s noticeable that between status of HIV/AIDS variant and infection to intestinal parasite there was a significant relationship Conclusion: High prevalence of intestinal parasites in HIV positive and AIDS patients in Khorramabad city reflects the necessity of prevention, screening, diagnosis and treatment programs for these patients. Key words: Intestinal parasites, HIV positive, AIDS patients, Khorramabad

The study of personal familial and psychological characteristics and drug abuse among in bed patients with suicide intention in Shohadaye Ashayer in 1383 Safa M1, Mohmoudi GhA2, Soultani far M3, Saki M4, Farhadi A5 1. Assistant professor, Department of psychology, Faculty of medicine, Lorestan University of medical sciences 2. Assistant professor, Department of forensic medicine, Faculty of medicine, Lorestan University of medical sciences 3. General practitioner 4. Instructor, Department of nursing, Faculty of nursing and midwifery, LorestanUniversity of medical sciences 5. Instructor, Department of psychology and health, Faculty of medicine, LorestanUniversity of medical sciences Abstract Background: Suicide is one of the social problem which brings about death of active characters in the society and it is considered as a remarkable problem for health. Suicide is the number 9 factor of death in America. Nearly 85 cases of suicide happen per day within 20 minutes each. Drug abuse is of psychiatric urgency and it is regarded as an important variable related to suicide. Materials and methods: All clients who committed suicide and were hospitalized in Shohadaye Ashayer hospital were included in this study ( from July 83 to January 83 ). Results: The results showed that there is a significant relationship between drug abuse and chronic organic disease among patients with suicide intention . Among 67 suicide cases, 55.2% were male and 44.8% were female. The highest frequency (55.2%) covered the age group (19–26) .Most of the cases were unmarried. 47.8% were unemployed . 79.1 % were city residents and 21.9 % were living in the country. 53.7% of the participants had elementary school and junior high school education . Conclusion: The study was to determine the frequency of personal, familial psychological characteristics and drug abuse among clients with suicide. The results emphasize on the preventive effect of the level of education in this Province. The results also showed that the more the number of people in the family, the more suicide cases in the family. Further more among married ones, cases with one or two children were prominent. Key words: personal characteristics, familial characteristics, Drug abuse, Suicide

Clonidine decreased intraoperative bleeding in rhinoplasty Sadri B1, Nadri S2, Poosti B3, Mahmoudvand H4 1. Assistant professor, Department of Anesthesiology, Faculty of medicine, Iran University of medical sciences 2. Assistant professor, Department of Anesthesiology, Faculty of medicine, Lorestan University of medical sciences 3. 1. Assistant professor, Department of ENT, Faculty of medicine, Iran University of medical sciences 4. General practitioner, Lorestan University of medical sciences Abstract Background: Intraoperative bleeding accounts one of the most disturbing complications during various surgeries including vertebral column surgery, head and neck surgery, plastic surgery especially rhinoplasty. To decline this problem, some techniques and drugs are used. We examined the effect of clonidine given as an oral preanesthetic medication in producing a bloodless surgical field in patients undergoing rhinoplasty. Materials and methods: A prospective, randomized, double-blind clinical trial was performed in 40 patients scheduled for elective rhinoplasty under general anesthesia. Patients had been divided randomly in two groups. 20 patients received only diazepam 0.1 mg/kg and 20 patients received both diazepam 0.1 mg/kg and clonidine 3 µg/kg orally 90 minute prior to arrival at the operating room. Method of anesthesia were simillar in two groups. Intraoperative bleeding was assessed on a four-scale from 1=no bleeding to 4= abundant bleeding and also amount of blood in suction and number of gauze that total bloody. These data were recorded in data collecting sheets. Results: There were no significant statistical difference in sex and means of age between two groups (p<0.05). Mean age was 24.9±6 years. The mean of gauze number in group that recieved clonidine was 1.9±0.9 and in other group 3.6±1.1. The mean blood volume in suction was 65± 28cc and 125±30cc (clonidine recieved and other group, respectively). Statistical analysis using independent sample T-test shows significant difference between two groups (p<0.001). Conclusion: Premedication with oral clonidine 3 µg/kg reduce bleeding in rhinoplasty and improve surgeon’s satisfaction. Key words: clonidine, rhinoplasty, intraoperative bleeding

Comparison of sexual satisfactory and depression between sterile and unsterile couples refer to Alzahra research and education center, Tabriz Satarzadeh N1, Bahrami N2, Ranjbar Koch-saraei F3, Ghojazadeh M4 1. Instructor, Department of nursing, Faculty of nursing and midwifery, Tabriz University of medical sciences 2. Instructor, Department of parastari, Faculty of nursing and midwifery,Ghazvin University of medical sciences 3. Assistant professor, Department of psychology medicine, Faculty of medicine , Tabriz University of medical sciences 4. Assistant professor, Department of physiology, Faculty of medicine , Tabriz University of medical sciences Abstract Background: Some studies show the depression, stress, low self-esteem, sexual dissatisfaction may be psychological outcomes of infertility. Depression and sexual satisfaction play a significant role in the life of infertile couples, their infertility treatment follow- up and in their hopefulness for the future. The present study was carried out to determine and comparing the depression and sexual satisfaction among infertile and fertile couples referring to Alzahra educational center in Tabriz. Materials and methods: This is a comparative- descriptive study in which depression and sexual satisfaction rate were studied and analyzed in 150 infertile versus 150 fertile couples. Sample selection was randomized. Data gathering was done by using questionnaire including 3 parts( Demographic characteristics of couples, Beck Depression Inventory and Larson standard questionnaire for determining sexual satisfaction). All data gathered for this study was analyzed by using descriptive statistically methods, mean difference tests and also relation test. Results: The BDI mean difference between infertile and fertile men and between infertile and fertile women was significant (p=0.011,t=2.54in men & p<0.005, t=3.68in women). But the difference between sexual satisfaction mean difference in infertile and fertile men and between infertile and fertile women was not statically significant (p=0.707, t=0.377 in men & p=0.370, t=0.898 in women). Mean difference in infertile women was higher than their husbands but sexual satisfaction score in men and women was not statistically significant. Also there was a negative correlation between sexual satisfaction and depression. Conclusion: Infertile couples are indigent to exact care and treatment about their psychological problems. Presence of expert counselors in infertility treatment teams for diagnosing and treating these patients before any delay, is quite necessary. Key words: infertility, fertility, depression, sexual satisfaction

Pregnancy outcome following M.MR vaccination Lorzadeh N1, Ghafarzadeh M1, Vahabi S2, Lashgar-ara GhR3 1. Assistant professor, Department of gynecology, Faculty of medicine, Lorestan University of medical sciences 2. Assistant profwssor, Department of anesthesiology, Faculty of medicine, Lorestan University of medical sciences 3. General practitioner, Information and drugs center of Lorestan health department Abstract Background: In this study we evaluate the outcome of pregnancy in the patient that received M. MR vaccine during M.MR vaccination program on Lorestan of fall 2003. Materials and methods: This is a descriptive epidemiologic study, we evaluated all of women that vaccinated with M.MR vaccine during pre and post conception. We collected and analyzed all of information like prognosis of pregnancy, congenital rubella syndrome, gestational age weigh of newborn. Results: In 92 pregnancy women infected with MMR vaccine, the prognosis of pregnancy clearly seen 88 pregnant women (96%) 73 (83%) had normal and healthy newborn infant and 5 (6%) had spontaneot abortion and 10 pregnant women (11%) had legal abortion. Mean gestational age at birth was 39.52.1 and weigh of newborn was 3257535 grams. None of the live born infants had not congenital rubella syndrome. Conclusion: In this study we showed M.MR vaccination during pregnancy had not any complication pregnancy. But pregnancy yet is an contraindication for M.MR vaccibnation, vecause this patient theories have risk of congenital rubella syndrome. Key words: pregnancy outcome, M.MR vaccination, pregnant women

Evaluation of the antibiotic susceptibility of Coagulase Negative Staphylococci in children Ghotaslou R1, Gharashi Z2, Pour-asl M3 1. Assistant professor, Department of pathobiology, Faculty of medicine, Tabriz University of medical sciences 2. Associate professor, Department of pediatrics, Tabriz University of medical sciences 3. Instructor, Department of pathobiology, Faculty of health, Tabriz University of medical sciences Abstract Background: The most common microorganism in blood cultures is Coagulase Negative Staphylococci (CNSt). Exact diagnosis of bacterial agents in blood and their antibiograms are an important value in septicemia therapy. The purpose of the present study is to identify and determine antibiotic susceptibility of CNSt isolated from blood in children. Materials and methods: Samples were collected from 270 patients with CNSt positive blood cultures during 2 years (2003-2004) in pediatric center of Tabriz by routine microbiological methods. The disc agar diffusion technique (kriby-Bauer) was used to evaluate the susceptibility test of CNSt. Results: In our study mean age of patients was 10 month. 54.4% and 45.6% were male and female repectively. In 270 CNSt, the resistance to Penicillin, Ampicilline, Cephalexin, Ceftizoxime, Ceftriaxon and Vancomycin were respectively 98.1%, 95.9%, 62.3%, 55.9%, 53.7% and 2.6%. Conclusion: Antibiotic susceptibility of CNSt is not predictable and multiresistant strains are common. Vancomycin is the drug of choice, since only 2.6% resistant CNSt were noticed. Key words: Coagulase Negative Staphylococci (CNSt), Antibiogram , Drug resistant.