Yafteh

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Abstract Backgroung: Recent studies have shown that Tramadol has local anesthetic effects in addition to its classical analgesic effect. In this study, the local anesthetic and postoperative analgesic effects of Tramadol were compared with those of Lidocaine in minor surgeries under local anesthesia. If the efficacy of Tramadol in this regard is proven, it will make considerable advances in the local anesthetic area. Materials and methods: In this random double-blinded clinical trial study, seventy patients aged between 20 to 50 in ASA physical status of I and II underwent subcutaneous block for minor surgeries. The patients were randomly assigned to receive either 2 mg/kg of Tramadol (group T, n=35), or 1 mg/kg of Lidocaine 2% (group T, n=35) subcutaneously. The mean degrees of pain sensation were recorded on the VAS (visual analogue scale 0-10) during injection, incision, and every 15 minutes at the 15th, 30th, and 45th minutes after the incision, and then every two hours at the 2nd, 4th, and 6th hours postoperatively in the ward. The data were analyzed using repeated measures and Chi-square. When the VAS of pain during surgery exceeded 4, an additional 0.5 mg/kg of the study drug was injected. The patients with the VAS of 4 or more were advised to take Acetaminophen 325 mg if necessary. Results: There were no significant differences between the pain score of the two groups during injection, incision, surgery, and postoperative time (p=0.181). Additionally, no significant differences were found in local skin reaction (p=0.104), bleeding quantity (p=0.112), additional dose of local anesthetic (p=0.48), and incidence of vomiting (p=0.114). The incidence of nausea (0 %) in group L and (22.8%) in group T, showed a statistically significant difference (p=0.002). In group L, need for Acetaminophen to control their pain was higher than in group T. Conclusion: Tramadol 2 mg/kg has equal local anesthetic and postoperative analgesic effects like Lidocaine 1 mg/kg for minor surgeries performed subcutaneously. Therefore, it is recommended that Tramadol can be used as an alternative drug to Lidocaine in local anesthesia because it is able to decrease the demand for postoperative analgesics.

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Background: Cognitive insight is a complex and multidimentional concept. The clinical measurements of insight have focused primarily on patients’ unawareness of their having a mental disorder and of their need for treatment. Modern approaches have focused on some of the cognitive processes involved in patients’re-evaluation of their anomalous experiences and of their specific misinterpretations. The aim of this study was the examination of factor structure of the Beck Cognitive Insight Scale (BCIS) in a nonclinical iranian sample. Materials and Methods: For this purpose, 476 university students, completed the Beck Cognitive Insight Scale (BCIS). The data were analyzed by LISREL and SPSS softwares. Results: The results showed that 2 main factors: Self-reflectiveness and Self-certainty which had been revealed primarily by Beck and his colleagues (2004) have been obtained as independent subscales in this research too. Conclusion: The results provided tentative support for the factor structure of the BCIS, and suggest that the BCIS is a valid measure to use in a non-clinical population.

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Background : Mastalgia is a one of the most common reasons for consultation to all the women who make repeated visits to health care centers.The aim of this research was to compare the effect of Evning primrose and Vitex on mastalgia . Materials and Methods: This study is a one-stage clinical trials which carried out on 210 women with Mastalgia whom were placed in three groups of 70. The first group: Vitex tablets, the second group: primrose capsules and the control group: vitamin E were given for 2 months. Before and 2 months after the intervention scores for chest pain were campared and evaluated by a questionnaire. The results were analyzed using SPSS software. Results: Results showed that the mean pain score in the intervention group has dropped and average days without pain have increased in the three groups and average days with moderate pain decreased in all three groups and average days with severe pain have decreased in all three groups (Cardiff chart) (p<0.0001). Statistical tests showed that the effect of Vitex has been more than the others (p<0.0001). Conclusion: The results showed that Vitex, has a good therapeutic effect on cyclic Mastalgia and can be used as an effective treatment.

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Background: One of the public health challenges in the worldwide is diabetes, and adherence to treatment is crucial. Adherence to treatment can help reduce the complications of the disease. Therefore, this study was performed to evaluate the status of adherence to treatment among patients with type 2 diabetes in Khorramabad.
Materials and Methods: In this cross-sectional study, 392 men and women with type 2 diabetes referred to comprehensive health centers in Khorramabad between May and August 2016 were studied. Demographic questionnaire and Morisky Medication Adherence Scale (MMAS-8) were used to collect data. Version 22 SPSS and descriptive analysis were used to analyze the data. Significance level in the present study was less than 0.05. Descriptive tests, Chi-square, Fisher's exact test, and independent t-test were used.
Results: The mean age of study participants was 56.03 ± 10.91. 68.9% (270 people) were women and 31/1% (122 people) were men. According to the score obtained from the Morisky questionnaire, a total of 219 patients (55/9%) followed the desired treatment and 173 (44/1%) followed the unfavorable treatment. There was a significant relationship between patients' adherence to treatment with the variables of gender, marital status, educational status, and their monthly income. No statistically significant between age and employment status with adherence to treatment were observed.
Conclusion: Findings of this study showed that adherence to treatment among patients with type 2 diabetes in Khorramabad is in a good level. Health policy makers should strive to ensure that all patients adhere to their treatment process with easy access to services and reduced costs.