Botulinum Toxin and Burn Induces Contracture

No abstract available.

Coping skills improve quality of life in women with Breast Cancer and Maladaptive coping style

Background: Breast cancer [BC] is a common malignancy among women. BC is a stressor in life that affects coping strategies and quality of life. This study performed to improve the quality of life in women with maladaptive coping style

Methods: A randomized clinical trial, held in 2011. Patients with maladaptive coping strategy were included in the study. 62 patients were randomized into two groups. Before and after 8 weeks of coping therapy, the quality of life was measured. General linear model was used for analysis

Results: The mean age in the intervention and control group was 45.10 +/- 7.34, 46.52 +/- 6.20 respectively [P-value>0.5]. Functional health significantly improved after the intervention [p-value<0.005], but in the control it decreased [p-value=0.029]. Symptom health between the two groups demonstrated no difference before and after intervention. General health improved in the intervention group [p-value=0.017]. However, in the control group it was not significant [p-value=0.128]. Problem-focused coping strategies in the intervention group improved markedly [p-value= 0.003] whereas, the control group did not reveal significant differences [p-value=0.196]

Conclusion: The results showed that the coping skill training program can improve the overall quality of life of breast cancer in women, and indicated that the care of breast cancer should address psychological issues and the finding points to the importance of taking individual coping strategies into account when evaluating the impact of breast cancer on psychosocial well-being

Group education and nurse-telephone follow-up effects on blood glucose control and adherence to treatment in type 2 diabetes patients

Training and continuous dynamic communication between patients and health professionals in chronic diseases like diabetes, is important. The aim of this study is to evaluate the effects of diabetes self-care group education and nurse- telephone follow-up on glycemic control and compliance with treatment orders in patients with type 2 diabetes attending to diabetes clinic in Khomein. In this clinical trial, 62 patients with type 2 diabetes who attending to the diabetes clinic selected and were randomly assigned to experiment and control groups. Self-care group education was applied for case group [n = 31] and they were followed up using telephone calls for 12 weeks by a nurse. The control group [n = 31] received the conventional management. Demographic characteristics, compliance with treatment recommendations [diet, drug use, exercise] and blood glucose control indices were recorded before and after interventions. Data were analyzed by SPSS software version 16 using independent t-test, paired t-test, Chi-square test, non-parametric tests, mixed model [ANOVA + repeated measure] and ANCOVA. The mean age of intervention and control groups was 50.9 +/- 7.3 and 55.1 +/- 10.1 years, respectively. Blood glucose indices [FBS, 2 hpp BS, Hb A1C] were improved in both case and control group after intervention but it was only statistically significant in case group [P > 0.0001]. During study, percentage of patients with very good compliance in control group decrease from 12.5% to zero [0%], whereas in experiment group these amounts increase from 6.5% to 90.3% [P > 0.0001]. According to the results of the current study self-care group education and 12 weeks follow-up by a nurse using telephone causes significant improvement in metabolic parameters and adherence to treatment recommendations in diabetic patients

role of lupus nephritis in development of adverse maternal and fetal outcomes during pregnancy

We aimed to investigate the relationship of lupus nephritis [LN] with fetal and maternal outcomes of pregnant patients with systemic lupus erythematosus [SLE]. In a retrospective study, profiles of pregnant women with SLE were selected. Before pregnancy and at the end of first, second and third trimesters, SLE disease activity index-2K was assessed. Clinical and laboratory evaluations were carried out regularly. Maternal and fetal outcomes were recorded. Assessments of the crude effects of statistically significant variables on pregnancy outcomes were performed through multivariate regression analysis. 72 pregnancies in 65 patients were recorded. The mean age of LN patients was 28.7 years, whereas the mean age of patients with clinical nephritis was 26.1 years. No woman with LN experienced pre-term labor or stillbirth. 16 pregnancies either ended in abortion or experienced preeclampsia of which seven had LN. Multivariate logistic regression analyses showed that LN and positive antinuclear antibody were related to preeclampsia, whereas age of SLE development was associated with pre-term labor. Combined maternal and fetal outcomes were associated with the past history of abortion and LN. LN was associated with preeclampsia and SLE flare. Absence of LN was in favor of prevention of SLE flare and preeclampsia

Internal motivations and barriers effective on the healthy lifestyle of middle-aged women: a qualitative approach

A healthy lifestyle is one of the basic health-promotion strategies. Several factors are involved in shaping health-promotion behaviors. The internal barriers are the opinion and feelings that surround the individual and are the reasons that complicate the change of behavior. The aim of this study was to identify internal motivations and barriers effective on the healthy lifestyle in middle-aged Iranian women. This was a qualitative study based on content analysis of in-depth semi-structured interviews with 21 middle-aged women in the city of Yazd, who were selected using purposeful sampling approach. The interviews continued until data saturation was reached; and the interviews were audio-recorded and transcribed exactly. The transcripts were analyzed. Five main themes emerged from the analysis of the interviews: Women's knowledge of health-promoting behaviors, importance of health and healthy behavior of women, affliction or fear of affliction to chronic disease and its consequences, responsibilities of women in the family and society, and skills of life management in women. The findings suggest that empowering individual participants in health promotion is the most important factor determining their health. Thus, designing appropriate programs for education and empowerment of people is essential to promoting health. Health policy makers, with knowledge of these factors, can design comprehensive, socialization programs to promote women's health.

Validation of Persian version of pedsQL[TM] 4.0[TM] generic core scales in toddlers and children

To evaluate the reliability, validity and feasibility of the Persian version of the Pediatric Quality of Life inventory PedsQL[TM] 4.0 [TM] 4.0 Generic Core Scales in Iranian healthy students ages 7-15 and chronically ill children ages 2-18. We followed the translation methodology proposed by developer to validate Persian version of PedsQL[TM] 4.0TM 4.0 Generic Core Scales for children. Six hundred and sixty children and adolescents and their parents were enrolled. Sample of 160 healthy students were chosen by random cluster method between 4 regions of Isfahan education offices and 60 chronically ill children were recruited from St. Alzahra hospital private clinics. The questionnaires were fulfilled by the participants. The Persian version of PedsQL[TM] 4.0TM 4.0 Generic Core Scales discriminated between healthy and chronically ill children [healthy students mean score was 12.3 better than chronically ill children, P<0.001]. Cronbachs' alpha internal consistency values exceeded 0.7 for children self reports and proxy reports of children 5-7 years old and 13-18 years old. Reliability of proxy reports for 2-4 years old was much lower than 0.7. Although, proxy reports for chronically ill children 8-12 years old was more than 0.7, these reports for healthy children with same age group was slightly lower than 0.7. Constructive, criterion face and content validity were acceptable. In addition, the Persian version of PedsQL[TM] 4.0TM 4.0 Generic Core Scales was feasible and easy to complete. Results showed that Persian version of PedsQL[TM] 4.0[TM] 4.0 Generic Core Scales is valid and acceptable for pediatric health researches. It is necessary to alternate scoring for 2-4 years old questionnaire and to find a way to increase reliability for healthy children aged 8-12 years especially, according to Iranian culture

Weight gain during pregnancy in women attending a health center in Isfahan city, Iran

Body mass index [BMI] before pregnancy and weight gaining during pregnancy affect infant birth weight and are associated with unfavorable pregnancy outcomes. The aim of this study was to describe the weight gain pattern of Iranian pregnant women according to the BMI status at the beginning of pregnancy. This was a longitudinal cross sectional study. A total of 500 pregnant women in 6[th]-10[th] weeks of pregnancy were enrolled and followed up through delivery. Body mass index categories based on first visit weight and total weight gain were calculated. The multiple analysis of variance [MANOVA] was used to compare the mean values of gestational weight gain. At the first care, those with underweight, normal, overweight and obese accounted for 10.7%, 46%, 35.9% and 7.4% of all participating women, respectively. Most of the subjects were in normal range of BMI [46%] at the beginning of the study. As BMI was more at the first visit, the recommended amount of weight gain was less achievable [70% versus 27%]. Although the average weight gain in obese women was less than other groups [9 +/- 7.9], about 55% of them were over the recommended standards of weight gain. In conclusion, in spite of frequent visits during pregnancy, only half of pregnant women had normal weight gain and most of them had normal BMI at the first visit. This study highlights the importance of considering women with abnormal pre pregnancy BMI and gestational weight gain at an increased risk and providing appropriate care for them to prevent future adverse outcomes

Linguistic validation of the irritable bowel syndrome-quality of life questionnaire for Iranian patients

There is a growing interest of clinical and epidemiological researches in the field of functional gastrointestinal disorders in our society. Accordingly, validated and culturally adapted instruments are required for appropriate measurement of variables specially the quality of life. The aim of our study was the linguistic validation of the Irritable Bowel Syndrome-Quality of Life questionnaire [IBS-QOL] for Iranian IBS patients with Persian language. Following the standard forward-backward translation method, the IBSQOL was translated into the Persian language and completed by 141 IBS patients. Patients also completed the IBS Symptom Severity Scale [IBS-SSS] and Hospital Anxiety and Depression Scale [HADS]. One-week retest was performed on 30 randomly selected patients. Internal consistency and test-retest reliability were assessed using Cronbach's alpha and intraclass correlation coefficient [ICC], respectively. To analyze the discriminant validity, the IBS-QOL scores was correlated to the IBS-SSS and HADS scores. According to the results, reliability analyses were acceptable for all of the IBS-QOL domains [Cronbach's alpha=0.68 to 0.90 and ICCs=0.77 to 0.91]. Discriminant validity was supported by the presence of correlations of the IBS-QOL scores with disease severity [r=-0.628], depression [r=-0.692], and anxiety [r=-0.711] scores; P<0.001. These results indicate that the Persian version of the IBS-QOL is a reliable instrument with sufficient psychometric requirements to assess quality of life in Iranian IBS patients with Persian language

Continuation rates and reasons for discontinuing Tcu380[A] IUD use in Isfahan, Iran

Objective: IUD is a highly effective, safe, private, long-acting, and rapidly reversible method of contraception with few side effects. The aim of this study was to assess the continuation rate and cause of IUD discontinuation in Isfahan, Iran

Materials and methods: This historical Cohort study was carried out on 12 randomly selected health centers of Isfahan province in 2007. 244 literate married reproductive aged women [15-49 years old] who had chosen IUD as a contraceptive method in 2002 enrolled the study by census sampling. After explaining the aim of study and taking informed consent, women completed the questionnaire for demographic characteristics, menstrual characteristics before and after IUD insertion and cause of IUD discontinuation. Data were analyzed by SPSS 11 software, descriptive statistics and Kaplan-Meier analysis

Results: Continuation rates at the end of 1, 2, 3, 4, 5 and 6 years were 100, 92, 87, 76, 66 and 65 per 100, respectively. Since 2001-2007, 60% [146] preserved and 40% [98] removed their IUD. 27.6% [27] discontinued IUD use due to occurring medical problems that the most common cause was infection [29.6%]. 72.4% [71] had voluntary IUD removal and the most common cause was tendency to planned pregnancy [38%]

Conclusion: These findings indicate that health care providers should give more emphasis to counseling programs for women desiring IUD insertion

[ effect of communication skills training through video feedback method on interns' clinical competency]

Introduction: There are methodological challenges on the subject of communication skills training despite general agreement on its advantages. This study was performed to compare the effect of communication skills training through video feedback with the usual method of lecture

Methods: This quasi-experimental double-blind prospective study was performed on two groups of 20 interns in the year 2005 in Isfahan University of Medical Sciences. First, both groups received education through lecture and immediately were tested by OSLER [Objective Structured Long Examination Record]. Then the video feedback was played for the experiment group. Two months later, the same examination was performed for the both groups. The result was analyzed by SPSS software using Mann-Whitney, Wilcoxon, and chi[2] tests

Results: No significant difference was observed between two groups considering gender, age, and the number of internship months. Scores achieved on OSLER-I revealed no significant difference between the two groups but, the discrepancy in OSLER-II was significant. The difference between scores of OSLER-I and OSLER-II was significant in the experiment group and insignificant in the control group. A significant difference was discovered in history-taking skill, physical examination, diagnosis, and treatment, before and after participation in the workshop in the experiment group

Conclusion: Communication skills training through video feedback improved interns' skills for history taking and physical examination. It also enhanced the accuracy of diagnosis and treatment. Emphasizing on necessity of communication skills training, it is also recommended to pay attention to advantages of video feedback method as an educational approach

[Evaluating healthy life style education to adolescents by means of direct method, parents, and teachers using CIPP evaluation model]

Introduction: Detrimental nutritional habits along with inactive life style in children and adolescents are severe threats to the health of this age group at present and future which predispose the society to chronic diseases for the next two decades. The aim of this study was to assess different methods of healthy life style education to adolescents considering the feasibility and applicability in school environment from the viewpoints of stakeholders and program administrators using CIPP [Context, Input, Process, Product] model

Methods: This field evaluation study was performed using CIPP model. 600 male and female students of intermediate schools in Khomeinishahr were selected and randomly assigned into 4 intervention groups including direct education to students [Group A], education by parents [Group B], education by teachers [Group C], and control group [Group D]. Education about healthy nutrition and appropriate physical activity was presented for a month using 3 different methods. The effectiveness of education was evaluated by interview with stakeholders and using questionnaire. Data related to evaluation of interventional program was gathered by a researcher made checklists adapted from CIPP checklist [Version 2007]

Results: The highest scores in the stages of "contractual agreements" and "program effectiveness" of CIPP checklist belonged to parents group [B] and direct education group [A], respectively. The results of stake holders' viewpoints [students, parents, and teachers] about the program showed that the highest score belonged to group A

Conclusion: This study recognized "direct education to students " as the most effective and practical method for healthy life style education to adolescents

[Healty lifestyle assessment questionnaire in elderly: translation, reliability and validity]

To develop and validate a questionnaire for measuring healthy lifestyle in Iranian elderly. This is a triangulation study, developed in Isfahan city 1385-86. An item pool was developed based on semi-structured interviews with elder people and experts in Geriatrics, literature review and other lifestyle questionnaires. We used principal-component analysis [used SPSS 15] and a focus group to reduce the items and assessment the face and content validity. Internal reliability was estimated using Cronbach's alpha coefficient. The questionnaire contains 46 items and 5 dimensions including exercise, nutrition, prevention, stress management and relationship. The validity was confirmed by experts and Cronbach's alpha coefficient was 0.76. The Elderly Lifestyle Questionnaire is a valid and reliable instrument and will enable researchers to investigate lifestyle patterns in the elderly and to assess the impact of interventions of lifestyle change in this population. The instrument warrants further testing and development with different elderly populations

Indicators of utilization as a means for assessment of health information management systems

Indicators are regarded as tools of evaluating different situations in all systems. Hospitals as a part of health systems are not an exception. They should also be evaluated based on different views, the main aim of this study was to determine the rate of utilization of hospital resources in Isfahan province. This is a descriptive, trend study which was carried out in Isfahan province. A total of 1920 data sheets collected from 1997 to 2001 were analyzed. These data belonged to 32 hospitals located across the province. The form was a validated tool for data collection and was used throughout the country. Total mean of be occupancy [BOR] was 42.2% during the study period. Training hospitals with 54.3% showed the highest rate while district hospitals were the lowest [41.4%]. The average length of stay [LOS] was 2.6 days. The length of stay in training hospitals was 3.6 days, 1.9 days in private hospitals and 4.4 days in the regional ones. Bed turn over rate was 3.3 days during the studied five year period. In the third world countries, the number of hospital beds is far less than the minimum required for the population. According to international standards, there should be three hospital beds for a thousand people in the community. In our country there is 1.5 beds per one thousand and despite this shortage, even this capacity is not correctly used so that more than 50% of hospital beds are vacant and since they stand far away from the right place

Epidemiologic evaluation of traffic accidents in Isfahan, [2002-2003]

More than 1.26 million people are killed each year as a result of road traffic crashes. Most of the road traffic fatalities occur in low and middle income countries. WHO reported that in 2020 more than 2.34 million people will be killed due to road traffic accidents. With study of pattern of road traffic accidents, we are able to prevent or decrease many of these fatalities. This is a cross sectional study which is done with cooperation of Isfahan Legal Medicine Center In this study record of the deceased who died of accidents from 1381 to 1382, and their cadavers were brought to different Isfahan Legal Medicine Centers for issueing burial permit, were examined and for every one of them a checklist was prepared. After data collection they were analyzed with software SPSS. Between 2002 to 2003, 1446 people died because of road accidents, 1202 [81.3%] of them were men and 244 [16.9%] were women had. The most frequency of mortalities were in motor cyclists, the age range of 16 to 20 years and the final cause of death was head injury. The least frequency belonged to bicyclists. The consequences of this study was not so much different specially from developing countries except for bicycling which has more mortality rate in other studies, whereas it has less mortality rate in our country, that is because of bicycle usage is less common in daily transportation of Isfahan