Quality of life in type 2 diabetic patients and related effective factors.

Background: Diabetes type 2, as one of the most important chronic diseases in the world, reduces quality of life in patients. Materials and Methods: Our research - as a descriptive analytical cross-sectional study - was performed on 120 type 2 diabetics in Tehran 503 hospital in 2008. Diverse domain scores of patients' quality of life were evaluated by SF-36 standard questionnaire. Gained data analyzed by SPSS 16.0 software through statistical tests including Pearson's correlation coefficient, Chi-square test, Independent T-test, Kolmogrov-Smirnov test, Mann-Whitney test, Kruskal Wallis test, ANOVA, and Fisher exact test. Results: Age had significant reverse relationship with physical functioning, vitality, mental health, and mental component score. Education level was just directly correlated to bodily pain. Marital status was correlated with social functioning and general health domains. Family income level was directly related to mental health and mental component score domains. No relation was found between years of disease duration, smoking status, workout status, diet follow-up, lack/presence of hypertension, and diverse domains of these patients' quality of life. Hyperlipidemia had meaningful reverse relationship to physical functioning, bodily pain, social functioning, and physical component score domains. Heart diseases had meaningful reverse relationship to physical functioning and mental health domains. Patients' physical component score had direct relationship to mental component score. Conclusion: Observed scores were meaningfully low in comparison with both healthy people and similar surveys.

[Attitudes and knowledge of HIV positive persons and high risk behaviors groups in Golestan, Iran]

The epidemic of HIV has been become worldwide. Infected people with HIV which are most intravenous drug users [IDUs] and/or people who have unsafe sex are important source of transmission of infection to other persons in a community. Since there is little known about the knowledge and attitudes of HIV positives about HIV in Iran, therefore we decided to measure the level of knowledge and attitudes of this group in Golestan province in compare with individuals with risky behavior. This cross-sectional study was conducted on 54 HIV+ persons and 134 people with high risk behavior individuals in 2007 year. Our study showed that HIV- [High risk group] cases had higher education level [P=0.034]. Rate of jobless was higher in HIV+ persons [P<0.001]. HIV+ cases had lower income [P=0.037]. Both groups had moderate knowledge and poor attitude on HIV/AIDS. Level of attitude in HIV+ positive persons was lower than high risk group [P=0.05]. It is concluded that these susceptible persons and also infected individuals with HIV regardless of their socio-economic levels need more continuous education in structured programs

[Assessment of factors affecting self-care behavior among women with type 2 diabetes in Khoy City diabetes clinic using the extended theory of reasoned action]

Many studies show that the only way to control diabetes and prevent its debilitating complications is continuous self-care. This study aimed to determine factors affecting self-care behavior of diabetic women in Khoy City, Iran based the extended theory of reasoned action [ETRA]. A sample of 352 women with type 2 diabetes referring to a Diabetes Clinic in Khoy City in West Azarbaijan Province, Iran participated in the study. Appropriate instruments were designed to measure the relevant variables [diabetes knowledge, personal beliefs, subjective norm, self-efficacy and behavioral intention, and self-care behavior] based on ETRA. Reliability and validity of the instruments were determined prior to the study. Statistical analysis of the data was done using the SPSS-version 16 software. Based on the data obtained, the proposed model could predict and explain 41% and 26.2% of the variance of behavioral intention and self-care, respectively, in women with type-2 diabetes. The data also indicated that among the constructs of the model perceived self-efficacy was the strongest predictor for intention for self-care behavior. This construct affected both directly and indirectly self-care behavior. The next strongest predictors were attitudes, social pressures, social norms, and intervals between visiting patients by the treating team. The proposed model can predict self-care behavior very well. Thus, it may form the basis for educational interventions aiming at promoting self-care and, ultimately, controlling diabetes

[Evaluation of Pender's health promotion model for predicting adolescent girls' quality of life]

Presently not sufficient attention is paid to adolescent health promotion in many countries, because of the widespread belief that adolescents are generally healthy. The purpose of this study was to evaluate predictors of adolescent girls' quality of life using path analysis based on Pender's health promotion model. The Pender's health promotion model served as the framework of this cross-sectional study, which included a total of 500 adolescent girls [grades 9-11] selected by stratified random sampling from 20 high schools for girls in 4 districts of Kashan province, Iran. Inclusion criteria were being in grades 9-11 and a written informed consent [from teachers, parents and the girls themselves]. Data were collected through interviewing the girls, the interviewers being trained persons, using several standard questionnaires [for perceived self-efficacy, perceived affect, perceived barriers, perceived social support; health promoting lifestyle, and health-related quality of life]. Data analysis was done using SPSS18 and LISREL 8.8, the statistical test being path analysis. All constructs of the health promotion model and health promoting lifestyle were significantly related to adolescent girls' quality of life. Perceived self-efficacy [beta =0.70, p<0/01] and perceived affect [beta =0.21, p<0/01] had the highest correlation with the quality of life. The model and the health-promoting lifestyle as a mediator accounted for 73% and 39% of variance in adolescent girls' quality of life, respectively. The findings of this study indicate that the health promotion model can be used to explain and predict the quality of life of adolescent girls. Thus, the Pender's health promotion model is recommended to health planners for promoting the quality of life in this population

[Pattern of physical activity and the promoters among adolescent girls of Isfahan]

Technology development has brought about the society with a sedentary life style and an increase in number of chronic diseases. Therefore, to change the pattern of physical activity in adolescents, the recognition of factors affecting such activities is of crucial importance. The aim of this research was to investigate the relationship between the pattern of physical activity in adolescent girls and their mothers' physical activities, attitudes, and some demographic characteristics. This cross-sectional stud was carried out on adolescents 226 girls aged 11-18 years in 2010. The study population was chosen using a cluster sampling method. Data were collected using a questionnaire of three sections including demographic data, adolescent's physical activity pattern, and attitude and pattern of physical activity in mother. Data were analyzed using chi-square test and Pearson correlation coefficient. Of 226 girls, 50% found to have 2.07 hours of moderate to strong physical activity while 26.5% with a sedentary life style. A significant relationship between the adolescents' physical activity pattern and the mother's physical activity and regular exercise was demonstrated [p<0.005]. Also, there was a significant relationship between the adolescents' regular exercise and the mothers' exercise. Statistically, a significant correlation between the mothers' attitude and educational degree and the level of physical activity was shown. According to our results, a sedentary life style among female adolescents is higher than expected which is associated with mother's pattern of physical activity and affected by the attitude and educational level of mothers. Therefore, it is recommended that part of the educational programs to increase the level of daily physical activity in adolescent girls to be focused on mothers

Effects of semelil [ANGIPARS[TM]] on focal cerebral ischemia in male rats

Cerebral ischemia is one of the main causes of long term disability and death in aged populations. Many herbal drugs and extracts have been used for the treatment of cerebral ischemia induced insults. This study was designed to investigate the protective effect of Semelil [ANGIPARS[tm], a new herbal drug, on focal cerebral ischemia in male rats. Male rats were divided into five groups: sham-operated, ischemic animals treated with distilled water as vehicle, ischemic animals treated with 1.10 and 100 mg/kg of Semilil respectively. Middle cerebral artery occlusion [MCAO] model was used in NMRI rats and neuronal injury analyzed in hippocampal CA1 sector after 48 hrs of Middle Cerebral Artery [MCAO]. Results of this study showed that treatment with semelil attenuated ischemic damages and has positive effects on focal cerebral ischemia

Does group prenatal care affect satisfaction and prenatal care utilization in Iranian pregnant women?

The need to provide high quality prenatal care services, which take account of women's views and specifically address their need for information, support and communication, has been advocated and group prenatal care, had been suggested as one of the ways to achieve this objective. The purpose of this study was to examine the impact of group versus individual prenatal care on satisfaction and prenatal care use. This was a cluster-randomized controlled trial with the health center as the randomization unit that conducted in 2007. Satisfaction was measured through a standardized questionnaire, and the Kotelchuck Adequacy of Prenatal Care Utilization Index was used to measure prenatal care utilization. We recruited 678 women [group prenatal care, [N=344] and individal prenatal care, [N=334] in the study. Women in group prenatal care model were more satisfied than women in individual prenatal care model in all areas evaluated, including information, communication, co-ordination and quality of care. Group care women were significantly more likely to have adequate prenatal care than individual care women were [OR=1.35 95% CI=1.26-1.44]. Group prenatal care was associated with a significant improvement in client satisfaction and prenatal care utilization. This model of care has implications for the planning and provision of prenatal services within public health system, which is moving toward a better quality health care, and increasing use of services

[Need assessment: sexual health education in family planning centers, Tehran, Iran]

This paper explores the sexual health education needs and appropriate content for such education in Tehran. 21 married female in reproductive age from Tehran were recruited using snowball sampling and participated in qualitative interviews using focus group techniques. Participants addressed four themes: women's sex education needs, husbands' sex education needs, behaviors that women dislike in their sexual relationship, women's ideas about sex education. Sex education needs encompasses various subjects including basic concepts of sexuality and sexual behaviors. A considerable number of women disliked some sexual behaviors and had questions along those lines. They believed that sex education can influence their sexual life in a positive way. Attention to cultural sensitivities, realities of couples' sexual relationship and conceiving their needs as it is, seems to help to design and implementation of a program that is going to meet people real needs

[ perceived of self care among general people living in south of Tehran, Iran]

Although in many developed and developing countries, self care is the most important part of primary care, in Iran it has not been supported as well as its values. The aim of this study was to assess the views of general people living in south of Tehran about self care. This was a population based study in which 1200 individuals aged 15 years and over were interviewed using cluster sampling. A structured interview questionnaire which including 5 sections on regarding demographic characteristics, views on general health, views on self care knowledge, interest and practice, views on barrier and enabler factors for self care, and views on sources of information was used. Content validity and cronbach's alpha coefficient was used for its validity and reliability. Data were analyzed through SPSS version 11. The mean age of participants was 27.9 +/- 5.2 years. Six hundred and fifty eight respondents [55%] stated they were not knowledgeable on self care, 986 [82%] and 1035 [86%], were interested and self rated themselves active regarding healthy life style, respectively. In practice, only fifty three participants [4%] were actually active in eating >/= 7 glasses of water daily, 31 [3%] stated they ate more than five portions of fruits daily and 51 [4%] did physical activity more than 3 hours weekly. The findings of this study have highlighted the significant role of information in doing self care activities

[Risk of preeclampsia in planned and unplanned pregnancies: a comparative study]

To determine and compare the risk of preeclampsia in planned versus unplanned pregnancies in Tehran, Iran. We studied 1800 pregnant women attending the urban and rural health centers of Shahr-e-Rey in Tehran for their routine prenatal care. The subjects were divided into 2 groups: Group a consisted of women with planned pregnancy and group B included women with unplanned pregnancy. Inclusion criteria were: gestational age less than 28 weeks at the time of entering the study and consent to take part in the research. Both groups were followed through their prenatal care and up to their delivery. The occurrence of preeclampsia was ascertained by the presence symptoms [hypertension and edema] in the prenatal visits. Hypertension was defined as systolic blood pressure > 140 mmHg or diastolic blood pressure > 90 mmHg measured on 2 separate occasions, at least 6 hours apart. There were 23 cases of preeclampsia in Group A [2.5%] and 37 cases in Group B [4%]. The difference between the two groups was not statistically significant [P=0.066, Odds ratio=1.635, 95% CI=0.96-2.77]. In multiple logistic regression analysis, there was no significant relationship between unplanned pregnancy and preeclampsia [P-value=0.081, Odds ratio=1.603, 95% CI=0.943-2.724]. There was no significant relationship between unplanned pregnancy and preeclampsia. As there is not enough evidence in the literature to support this finding, larger studies are recommended to evaluate the relationship between unplanned and preeclampsia

[Postretirement employment and quality of life [QOL] indicators]

The number of elderly persons in our country [more than 7.8% of Iran population] is increasing more and more. Tehran province has the most number of retired with male to female ratio: 2/1. So, in the field of [quality of life] [QOL] increasing needs for giving care [physical and socioeconomic] to these groups have been appeared. In view of the aging process in our population there is a need to identify effective methods to prevent disadvantageous effects of this trend. The main purpose of this research was assessment and comparing of health-related quality of life [HRQOL] between retired staffs and labors. Also the effect of postretirement employment on HRQOL was explored. This study was carried out cross-sectionally and with the participation of 80 retired labor men and 80 retired staff men in Tehran University of medical science. The main purpose of this research was assessment and comparing of QOL items between retired staffs and labors. Also the effect of postretirement employment on QOL items was explored. Other variables such as; age, marriage status, education grade, house ownership were assessed too. In this research, we studied QOL variables in terms of quantitative and used t test. Finding showed that in retired staffs and labors, there was significant difference between quality of life variables. In other word, in staff group in comparison with labors group, there was better state from aspect of physical function, role- physical limitation, general health, social function, mental health, role-emotional limitation, total scores of physical health, mental health and quality of life. These differences were significant. There was a significant relationship between postretirement employment and quality of life [QOL] variables such as: physical function, role- physical limitation, role-emotional limitation, vitality, total scores of physical health, mental health and quality of life. Quality of life in elderly and retirees has relationship with all aspect of health and been influenced by many factors such as economic, mental, physical and social factors. So, based to these conclusions and similar studies, we can go toward quality of life promotion and increasing of community participations. Doing educational, cultural planning and policy making base upon real needs of elderly and retired can be mentioned. The overall improvement of self-reported QOL among elderly people suggests that the onset of disabilities could be postponed, especially if health-related circumstances were more evenly distributed at the start of or even before retirement age. These results suggest we should design appropriate programs to increase elderly people's interaction with others and establish new social networks for them which may enhance a sense of positive self-concept

Adverse events following immunization with DTP vaccine in infants and children in kermanshah city: a cohort study

The DPT vaccine used in Iran is manufactured by the Razi Institute. So far, there have been no studies to determine the incidence and severity of adverse reactions to this vaccine. It was this lock of reliable information, plus concern for the unfavorable effects of such reactions on compliance with the vaccination schedule, that prompted the current study on DPT side effects. In this cohort study, 1910 children aged 0 to 6 were divided into different groups [cohorts] on the basis of factors such as injection site and then monitored for the appearance of adverse effects. Data for this study were gathered through questionnaires filled by telephone or house-to-house interviews. We interviewed parents of children attending the 46 urban health clinics in Kermanshah. These interviews produced the data needed to fill the first port of the study questionnaire. The investigators then gave each parent on "information sheet" containing the data necessary for the second part of the questionnaire. The interviewee was asked to record on this sheet any adverse effects occurring over the following 48 hours. At the end of this period, the parent was contacted via telephone to fill the second part of the questionnaire. Data thus gathered were analyzed using the Statistical Package for Social Sciences [SPSS], version 11.5. In 1910 DTP immunizations given to children 0 to 6 years of age, followed for the development of adverse events occurring within 48 hours after immunization, the cumulative incidence rates were as follows: Swelling, 40.66% 38.43-42.89%]; Redness, 43.08% [40.84-45.32%]; Pain, 67.32% [65.20-69.40%]; Fever [>38°C] 54.14% [51.89-56.40%]; Fever [>40.5°C] 1.11% [0.64-1.59%]; Drowsiness, 33.35% [31.21- 35.48%]; Persistent crying, 13.35% [11.81-14.88%]; Local reactions, 75.79% [73.86-77.73%] and Systemic Reactions, 69.84% [67.76-71.97%]. Only one child developed convulsion following immunization. Varying reaction rates in different studies, such as high rate of pain and persistent crying in this study, may reflect the different preparations that were used or differenced in the methods for vaccine evaluation. Moreover, because of the severity of systemic reactions, DTP vaccine should be administered in the thigh region

Quality of life in women with different intensity of low back pain

It is widely believed that pain has a profound effect on health related quality of life. This study was conducted to assess quality of life in patients suffering from different density of chronic low back pain. The sample consisted of 101 patients with chronic low back pain attending to the Rheumatology Research Center of Tehran University of Medical Sciences between July and September 2003. All patients were female, married, aged 18 years or over and underwent rheumatologic clinical examination. Data were collected by face-to-face interviews using the Iranian version of the Short Form Health Survey [SF-36]. Relative to mean score of bodily pain, patients were divided into 2 groups: severe pain group [group 1] and mild pain group [group 2]. Then, quality of life scores was compared between these two groups. Independent sample t-test was applied and the results showed that there were significant differences between quality of life scores among people with different intensity of low back pain in all dimensions but the role emotional and social functioning scales. The findings from this study confirm that quality of life in patients with low back pain depending on its intensity may vary

[Back school in low back pain: a single blind randomized trial]

Back school was developed as a preventive measure for reducing low back pain in those who suffer from the disease. Despite diversities in approaches. all back school programmers involve classes in which patients receive theoretical and practical information to know their back and to cope with their limitations. Some studies showed benefits of back school including reduction in pain severity and functional disability in the short and medium terms. The purpose of the present study was to evaluate the short term effect of the multidimensional and interdisciplinary modern back school program in women with chronic low back pain in Tehran, Iran. This was a randomized controlled clinical trial carried out in Teheran, Iran. All 102 eligible women with chronic low back pain were randmly allocated to either back school program [n = 50] or control group [n = 52]. The back school subjects received 5 group sessions of back school education over 12 hours and followed up weekly until 3 months but control group was not offered any education. The two groups underwent physician visits and medication. Outcome variables were the pain severity as well as measures of physical, social and emotional functioning using the SF- 36 questionnaires. The findings indicated a significant improvements in pain, physical, emotional and social functioning scores in the back school group compared to control group. Although pain reduction was reported in both groups after 3 months but the difference was significantly greater for the back school group. Also regression analysis showed that back school program was the best predictor for improving low back pain. The back school program is an effective measure in reducing pain severity in those who suffer from low back pain

[Effects of Morphine dependency on the ovarian folliculogenesis following superovulation in mice]

Opioids may affect hypothalamic GnRH secretion and Hypothalamic-Pituitary- Gonad axis, resulting in reproductive disturbances. Current study investigates the effects of morphine on structure of ovary following superovulalion through morphologic/morphometric studies. Twelve young female NMRI mice were allocated into treatment and control groups. Treatment group received oral morphine at final dose of 0.4mg/ml for 21 days. Physical dependency was proved by injection of naloxone [2mg/kg ip]. The mice were superovulated by 10 iu PMSG [ip] and 48 hours later were sacrificed by cervical dislocation. Ovaries were removed and H and E staining was done. Every 10[th] serial section, which represents nonrandom 10 percent sample was counted. Follicles were classified into small, growing, antral and atretic according to the diameter and number of follicular cell layers surrounding oocytes. The volume and the weight of ovaries were recorded. In addition, the diameter of the antral follicles and oocytes was carefully measured by a calibrated oculometer. The volume and the weight of ovaries showed no significant alterations in the two groups. The proportion of small and atretic follicles was statistically different in treatment and control groups [P<0.001]. According to our data, oral morphine did not alter the volume and the weight of the ovary. However, folliculogenesis was moderately affected by morphine and following superovulation the behavior of ovaries in the treatment group is comparable to the control group

Maternal height as a contributory factor towards birth of small for date infants

A case control study of "small for date" and premature infants was conducted at 17 hospitals in Tehran between December 1989 and June 1990. The study population consisted of mothers of 347 small for date, 261 premature and 1164 normal infants. Mothers who were less than 18 years old and their height less than 155 cm had a statistically significant R. R, F.+ [2.18] for the birth of small for date infants, while mothers of the same age group but with a height of 155-159 or 160-165 cm had an R.R.F. of 2.61 and 1.41, respectively. It was therefore concluded that an increase in height did not decrease the R.R.F. for birth of small for date infants in teen-age mothers. Mothers older than 18 years, 18-29 and 30-39 years with a height of less than 155 cm had an R.R.F. of 1.63 and 1.47, respectively, both being statistically significant concerning the birth of small for date infants. Whilst in mothers taller than 155 cm and older than 18 years no significant risk factor was noted, it was concluded that a maternal height of less than 155 cm seems to be a contributory factor to birth of small for date infants. In this study no association was established between maternal height and prematurity. Since 57% of LB W t infants were small for date, any measures aiming at decreasing this figure would be beneficial to the individual as well as to the community. Short-term measures such as marriage at an older age, availability of contraception to teen-age mothers, and more years of education for girls may help decrease the proportion of small for date infants

Neonatal mortality in relation to birth weight

730 low birth weight [LBW] neonates and 1460 controls were selected from 13,123 neonates born from October 1988 to June 1989 in 17 hospitals and maternity units in Tehran, and were compared for mortality in the first seven and up to 28 days of life [early neonatal period]. In this study all low birth weight newborns are divided according to four sub-groups of birth weight, and the mortality within the first seven [early neonatal mortality] and up to twenty eight days of life [neonatal mortality] is examined in both groups. Part of the results are as follows: 1- low infants comprise 5.6% of total newborns, 2- 14.3% of LBW neonates die within the first seven days of life, 3- 75% of very LBW neonates [less than 1500 g] die within the first seven days of life, 4- low birth weight neonates have a mortality rate twenty four times that of normal birth weight infants in the first and fourth weeks of life, 5- neonatal mortality rate in this study was 18 per thousand