[Job burnout and some of its risk factors on the health workers (Behvarz) in Koohrang County, I.R.Iran, in 2010]

Emotional exhaustion, depersonalization and lack of personal accomplishment are three dimensions of job burnout. Symptoms occur when employees' abilities and skills are not match with job demands. In a health care organization, staffs are exposed to physical, mental and emotional stresses and predisposed to job burnout. In this survey we studied Job burnout and some of its risk factors among Koohrang county Rural Health Workers [RHW or Behvarz] in 2010. This descriptive-analytical study designed to assess job burnout dimensions in RHW of Koohrang county in 2010. Total koohrang county RHW [n=81] entered to the study. Two types of questionnaires were used for data collection: 1] Demographic data questionnaire include of age, sex, marriage status, level of education, type of employment and working years. 2] Maslach Burnout Inventory [MBI] as a common valid questionnaire for assessment of job burnout. The reliability and internal validity of MBI questionnaire had been proved in previous studies. Data were analyzed by SPSS using ANOVA, spearman correlation and simple t tests. In different dimensions of job burnout, frequency of high lack of accomplishment, high emotional exhaustion and high depersonalization were 24.5%, 4.6% and 2.7% respectively but severity of emotional exhaustion and depersonalization were 6.7% and 1.3%. None of them reported severe lack of personal accomplishment. The relation between demographic factors and job burnout was not statistically significant [P>0.05]. There were significant correlation between emotional exhaustion and depersonalization and between personal accomplishment and emotional exhaustion [P<0.001]. The study shows that frequency and severity of job burnout in different dimensions are low. It could be explained by their appropriate socioeconomic status, short distance to workplace as one of its advantages, job security, low level of life expectations accompanying with nice climate

[ prevalence of antithyroid antibodies in women with polycystic ovary syndrome in Shahrekord, Iran]

Polycystic ovarian syndrome [PCOS] accompanied with obesity and insulin resistance. Many findings have shown that fat tissue has an important role in creating and resisting of various disorders in PCOS. On the other hand, thyroid has an obvious and dominant role in metabolism [specially in the metabolism of lipids and carbohydrates]. Both PCOS and thyroid diseases are accompanied with disruption in function of hypothalamus - pituitary -gonad axis. This study aimed at finding the relationship between antithyroid antibodies and polycystic ovary syndrome. In this descriptive analytical study two groups of 54 women with the age ranges of 15 to 45 years from Shahrekord, Iran were selected and consecutively were entered the study. The first group [control group], did not have any thyroid disease, systemic disorders or PCOS based on the history, physical examinations and blood tests and they did not use any medicine. The second group [patients groups], did not have any thyroid diseases and systemic disorders based on the history, physical examinations and blood tests but they had PCOS. Antithyroid antibodies in both groups were measured and compared using K[2], t test and ANOVA. There was no significant difference in the prevalence and levels of antithyroid antibodies between PCOS group and control subjects [P>0.05]. The level of [T3] and [T4] was significantly higher in polycystic ovary syndrome than in control group [P<0.05]. It does not seem that to be more prevalent than in the healthy women and it is unlikely that they have an important role in pathophysiology of the disease

[Determination the sedative effect of intravenous Dexamethasone with and without superficial scalp arteries compression in acute migraine attack]

Background and aims: The migraine headache is usually one sided, vary in intensity and duration, lasting from several hours to three days. It is often accompanied by nausea, vomiting, and sensitivity to light and sound. Its diagnosis is based on IHS criteria and there is several methods for the treatment: drugs such as triptans and sedatives, relaxation method and compression on superficial scalp arteries. The aim of this study was to determine the effect of intravenous Dexamethasone with and without superficial scalp arteries compression in acute migraine attack

Method: In this clinical-trial study, 200 ambulatory volunteer patients affected with migraine were randomly divided into two groups. Control group were injected Dexamethasone [8 mg, i.v.] only and case group received Dexamethasone [8 mg, i.v.] as well as superficial scalp arteries compression. Pain scores were measured in both groups before and after intervention according to HIS criteria. Data were analyzed using Mann-Whitney, Chi-square, Wilcoxon and one way ANOVA tests

Results: The average age of patients was 31.4+/-11 years and 74% of patients were female. The ratio of migraine without aura to migraine with aura was 10 to 1. Pain score was decreased in both groups after the intervention [P<0.01] and pain relieve in case group was significantly more than control group [P<0.05]

Conclusion: A brief superficial scalp arteries compression along with Dexamethasone injection can relieve migraine pain better than Dexamethasine alone

[Effect of shir-e-khesht [billinaster drop] consumption by the neonates or their mothers on the neonatal icter]

Background and aims: Icter is one of the most common problems found in a newborn baby. The risk of icter is related to the development of kernicterus. The neonatal icter is treated with photothrapy and exchange transfusion. In the Iranian traditional medicine shirekhesht from cotoneaster species plant is commonly used in the treatment of neonatal icter. This research aimed to investigate the effect of billineaster as an oral drop formulation on neonatal icter

Methods: In this clinical trial 4 groups each with 30 members were compared after adjustment of age and billirubin level. The first group was treated with photothrapy and only their mothers received billinaster. The second group was treated with photothrapy and the mothers and neonates received billinaster. In the third group only neonates recived billinaster and photothrapy and the last group was treated with phothothrapy and placebo. Serum billirubin level was assayed 12 hr, 24 hr, 36, 48 and 72 hrs after treatment. Data were analyezed using Chi square, Variance analysis, Kruskal - Walis tests

Results: The level of billirubin was significantly decreat in all t groups [P<0.05]. There was a significant difference in the level of billirubin between the case and control groups [P<0.05] after 24 and 36 hrs, of treatment. The arerage time of hospitalization in the case groups was 35.3+/- 15 and in the control group 70+/- 2.21 [P<0.05]

Conclusion: The result of this study showed that consumption of billinaster drop can cause a significant decrease in neonatal icter and also decrease in the hospitalization period. So, usage of the standard billinastar drop in order to cure the neonatal icter is suggested

[ effect of Hemoglobin changes on postoperative shivering]

Background and aim: Postoperative shivering is a common complication of anesthesia. Some studies reported that hemodilution induced anemia can reduce postoperative shivering. In this study, we evaluated the correlation between the hemoglobin index and changes on post anesthesia shivering

Methods: In a descriptive-analytical study, 117 patients aged 16-60 years were participated. Preoperative and postoperative hemoglobin index was measured. The level of hemoglobin was evaluated in 3 steps; before operation, 1 and 6 hours after operation. Postoperative shivering was evaluated by Crossly-staging. The collected data were analyzed by SPSS 17.00 software, using repeated measures analysis of variances and Spearman correlation tests

Results: From the total of 117 patients, 21 patients [17.9%] demonstrated postoperative shivering. The mean hemoglobin levels in patients with and without shivering before the operation were found 14.70+/-2.38 and 15.14+/-2.25 mg/dl, respectively [P>0.05]. After the operation, the mean hemoglobin levels in two groups were 13.28+/-2.36 and 13.64+/-2.05, respectively [P>0.05]. Finally, measuring hemoglobin levels in both groups six hours after the operation, were found 13.08+/-2.2.10 and 13.52+/-2.49, respectively [P>0.05]. No correlation was observed between the hemoglobin levels and shivering stages [P=0.085]

Conclusion: According to results of this study, there is no correlation between hemoglobin level and postoperative shivering

[ prevalence and antibacterial susceptibility pattern of enteropathogenic Escherichia coli [EPEC] strains isolated from less than 5 years old children with diarrhea hospitalized in Shahrekord Hajar hospital -2007]

Enteropathogenic Escherichia coli [EPEC] strains are among the most important diarrheagenic agents in developing countries. This study aimed to determine the common serotypes and antibacterial susceptibility pattern of EPEC strains isolated from less than 5 years old children with diarrhea hospitalized in Shahrekord-Hajar hospital in first six months of 2007. A total of 50 rectal swabs were collected from less than 5 years old children with diarrhea. In addition, 50 rectal swabs were obtained from outpatient children without history of diarrhea and gastroenteritis as control group. Stool samples were cultured on differential media EMB and Mac Conkey agar and incubated overnight in 35°C. Standard biochemical tests [IMVIC] were used for identification of bacteria. Confirmation of isolated bacteria as EPEC strains was performed with specific antisera [Bahar Afshan-Tehran] using slide agglutination method. Besides, antibacterial susceptibility pattern of 13 EPEC isolates against some common antibiotics: cephalotin, ampicillin, nalidixic acid, sulfamethoxazol- trimethoprim, gentamicin, ceftriaxone, ciprofloxacine and nitrofurantoin was evaluated using disk diffusion method. Data were analyzed using t-test, chi-square and logistic regression. EPEC strains were isolated from 26% of the children with diarrhea [13 patients] compared with 4% of children without diarrhea [2 cases]. Our data showed that fifty percent of the EPEC isolates were belonged to O44, O125, O126 and 0128 serogroups. In addition, 33.3% of the EPEC isolates were belonged to O20, O114 serogroups and finally, 16.6% were belonged to O26, O55 and O111 serogroups, Nitrofurantoin, ciprofloxacin and gentamicin were the most effective antibiotics against EPEC bacteria. The prevalence of EPEC demonstrates the important role of these strains in causing of acute diarrhea in children. Therefore, we suggest the application of routine diagnostic tests for identification and serogrouping of EPEC strains in bacteriologic laboratories

Seroprevalence of mumps before inclusion of mumps vaccination in the Iranian Expanded Programme on Immunization

The current target groups for measles, mumps and rubella vaccination in the Islamic Republic of Iran are children at 12 months and 4-6 years. A study of the age-specific seroprevalence of antibodies against mumps in children aged 3-18 years in Shahrekord aimed to establish the need for booster vaccinations to cover non-immune children. Of 338 children, 19.8% were seronegative. Age-specific seronegativity was 33.3%, 20.5% and 4.6% in age groups 7-11, 12-14 and 15-18 years respectively. To obtain herd immunity, we suggest that for the next 5 years children aged 7-11 years entering guidance school are selected as the main group for vaccination

[Comparison of growth parameters of infants of Ramadan fasted and non-fasted mothers]

The many advantages of exclusively breast feeding infants are documented: breast-feeding enhances the growth and development of breast fed infants. The impact of Ramadan fasting by breast-feeding mothers on the growth parameters of exclusively breast-fed infants is still not clear. The aim of this study was to evaluate the impact of maternal fasting during Ramadan on the growth parameters of their exclusively breast-fed infants. This cohort study was performed throughout Ramadan and for five months after, on healthy, exclusive breast-fed infants [n=116], aged between 15 days to 6 months, assigned into two groups based on their mothers fasting: Control group [n=80] and fasting group [infants with fasting mothers: n=36]. All infants underwent periodic physical examinations twice in Ramadan, 3 times in the second month and then twice monthly in next 4 months. The infant's growth status was evaluated by calculating each growth parameters [weight, height, head circumference] as a percentage of the median value for age, based on appropriate growth charts. The mean age of infants in the case group was 3.43 +/- 1.38 and in the control group was 2.31 +/- 1 45 months age being significantly different between the two groups [P<0.05]. Fifty-four [46.6%] were boys and this proportion was the same in both groups [P>0.05]. According to the repeated measures ANOVA, all growth parameters increased during the study period [P< 0.05] but the rate of increasing was the same for both groups [P>0.05]. Ramadan fasting by breastfeeding mothers did not adversely affect on the growth parameters of exclusively breast-fed infants

[Comparison of bacterial contamination of raw and pasteurized milk used in Shahrekord in 2006]

Milk is very important for the human nutrition. Control and monitoring of its preparation, transport, storage and presentation, based on healthy principals is essential. Therefore, this study was aimed to compare bacterial contamination of raw and pasteurized milk used in Shahrekord, Iran in 2006. This descriptive-analytical study is a descriptive analytical which has been done in 2006 in milk production factories in Shahrekord Township. In this order, 300 samples of raw milk using sterile containers of 200 cc volume, from five points and also randomly 120 samples of pasteurized milk from milk production factories have been gathered, on winter and summer seasons. Coli forms measured using MPN method in lactose broths medium and total count method used for the total bacteria in violate red bile Agar medium. E. coli determined in eosin methylene blue medium and IMVIC tests were used for coli form differentiation. Data were analyzed using descriptive statistics and Chi-square, Mann-Whitney, and Kruskal-Wallis tests. The results showed that 208 of 300 [70%] and 242 of 300 [80.5%] of the raw milk samples were contaminated with E. coli and coli forms, respectively. The most [88%] and the least [%58.3] rate of contamination were in the samples from southwest and northeast area, respectively [P<0.05]. The rate of contamination of raw milk prepared during summer with E. coil and coli forms were more than those prepared in winter [P<0.05]. Regarding the contamination of raw milk with E. coli and the other coli forms, particularly in summer, following of healthy principles and supervision in preparation, transport, storage, and selling of milk especially during the hot seasons are necessary

[ effect of maternal Ramadan fasting on growth parameters of their breast-fed infants]

Breast feeding is the best feeding pattern for infants. As a large number of mothers are fasting during the Ramadan, the aim of this study was to determine the impact of maternal Ramadan fasting on growth parameters of the infants whom fed only with maternal breast milk. This cohort study was performed from the beginning of Ramadan till the end of the following month in 1385. A total of 60 infants who fed only with maternal breast milk aged ranging from 15 days to 6 months were selected. Based on their mother fasting, they were divided in two groups of case [27 infants who their mothers were fasting] and control [33 infants who their mothers were not fasting]. The growth statue of the infants were evaluated using parameters weight, height, head circumference, during Ramadan and the following month. Using descriptive and analytical statistics, analysis of variance and independent t-tests data were analyzed. The mean age and sex of the infants was the same [P>0.05]. Weight, height and head circumference of the infants increased by 21, 7 and 6 percent, respectively during the study [P<0.05]. The repeated analysis variance showed that there was no significant difference in increasing of growth parameters between fasting and non-fasting mothers [P>0.05]. Ramadan fasting of mothers with exclusively breast-feeding infants did not adversely affect on the growth parameters of their infants

Comparison of perspective of children with major thalassemia and their parents about their quality of life in Shahrekord

In addition to control of the disease, improvement of quality of life is important for treatment of the patients suffering from bleeding disorders such as thalassemia. The impact of thalassemia and its complications on the quality of life of these patients and parents perspective has been little studied. Therefore, the aim of this study was to compare the perspective of children with thalassemia and their parents about the quality of life of these children. In this descriptive-analytical study, the quality of life of 39 children with thalassemia referred to Hajar hospital of Shahrekord was studied using a quality of life questionnaire [pedSQL]. Opinions of the children and their parents about physical, social, emotional and school functions of the children were collected. The data was analyzed using t-test, Manvitni and Hebsti Spirman tests. Perspective of the children and their parents about the mean of quality and quantity of life in the children was 1.06 and 1.43, respectively [p<0.001]. With respect to school and social life, there was no significant difference between the quality of life of the parents and the children. However, in physical [p<0.05] and emotional [p<0.001] aspects, there were significant differences between the two points of view. With respect to physical situation, quality of life of the girls was worse than that of the boys [p<0.05]. Overall, quality of life of rural children was lower than that of the urban ones [p<0.001]. Perspective of children with major thalassemia and parents abort quality of life especial abort emotional and physical is different. With respect to the role of parents in education of children, administration of programs to improve psychological health in children along with their the patients is recommended

Seroprevalence of anti-Toxoplasma antibodies among pregnant women from Chaharmahal and Bakhtyari province using indirect immunoflurescent in 2006-2007

The most serious form of Toxoplasma gondii infection, congenital toxoplasmosis occurs when a non-immune woman is affected during the pregnancy. Thus, having knowledge about Toxoplasma seroprevalence among women during childbearing ages and /or pregnancy is of public health importance. Therefore, this study was performed to determine the seroprevalence of Toxoplasma antibodies during the first trimester of pregnancy in women aged 15-45 years referred to the health centers of the province. In this descriptive-analytical study, 384 serum samples from pregnant women aged 15-45 years during the first trimester of their pregnancies were examined and tittered for anti-Toxoplasma antibody using Indirect Immunofluorescent Antibody [IFA] method. Using X[2] test, the data were analyzed. Total anti-Toxoplasma antibodies were found in 106 women out of 384 [27.6%], with serum levels ranged between 1:20 and 1:2560. The highest rate of anti-Toxoplasma antibodies was found in pregnant women aged 40-45 years [50%] [p<0.05]. There was a past history of spontaneous abortion in 29.3% of the sero-positive subjects. Also, 38.5% of the sero-positive women had a history of cat keeping in their house or had a close contact with the animal [p<0.05]. There was also a history of lamb meat consumption in 82.2% of sero-positive subjects [p<0.05], while the rate of anti-Toxoplasma antibodies was 65% for raw vegetables consumers. The highest and the lowest rates of anti-Toxoplasma sero-prevalence occurred in Shahrekord [51.9%] and Farsan [6%] districts, respectively. This rate was also 25% and 29.5% for urban and rural areas, respectively. The findings showed that a large proportion of pregnant women from this area are at risk of infection with Toxoplasma and may be infected during next months of their pregnancies or in their further pregnancies

Sound level in a ten year period in Shahrekord City

Noise is part of daily life in all human societies. It, like other pollutants, decreased the quality of life and is a hazard for public health. Therefore, the aim of this study was to find field data with respect to noise in the urban areas and to use data for applying measures to limit and control the exposure rate to environmental noise. In this study, sound level was measured across the city based on heavy, moderate, and light traffic jams; residential, educational, and remedial areas. Measurement was conducted in two times, 1992 using 8 stations and 2001 using 10 stations. To determine the noise level based on the public opinions, 20 persons were randomly selected in each overcrowding station and interviewed. The data was analyzed using Wilkoxon, chi-square and binomial analyses. The average of daily sound level in the first and the second period was 68.8 +/- 6.3 and 61.6 +/- 5.1 dB, respectively. The average of night sound level in the first and second period was 73.8 +/- 7.7 and 62.6 +/- 5.9 dB, respectively [p>0.05]. The average of sound variations during day and at night was 24 +/- 5.2 and 24.5 +/- 5 dB in the first period and was 28.8 +/- 8.7 and 23.4 +/- 4.5 dB in the second period, respectively. Twelve percent of the citizens in the first and nineteen percent of them in the second period complained about noise pollution. As one of the most important environmental problems, noise was ranked fifth and third in 1992 and 2001, respectively. Our results showed that civilization patterns are improved slower than growth rate of noise-causing factors across the cities

[Knowledge, attitude and practice about breast cancer screening and related factors among women referred to health care centers in Boroujen in 2005]

Breast cancer is common cancer in women and in the USA it is the forth cause of death. Breast cancer screening is the best method for early detection of this cancer. His study designed to assess knowledge, attitude and practice about breast cancer screening and dependent factors in women referred to health care centers in Boroujen city. This research was descriptive-analytic study in 400 women aged above 20 years. Data collected by a questionnaire and analized with SPSS. Deta analysis done using logistic regression and chi-square tests. Knowledge of records about breast self-exam, physical exam and mammography were 37.8%, 7.8%, 6%, respectively. 47.1% of records had tendency to BSE, 71.2% to physical exam and 68.9% to mammography. 4.5% of cases performed breast self-examination [BSE] monthly. In 16.3% physical exam performed for screening. 4.3% of women screened by mammography. The most important factor for performance of BSE was history of benign breast diseases in herself [p<0.05]. There was significant relation between history of benign breast disease, education level parity and clinical examination [p<0.05]. History of benign breast disease and history of using hormone were important factors on performance of mammography [p<0.05]. Because of low knowledge and poor practice, educational program to train women is most recommended

Comparsion of atracurium and succinylcholine on post adenotonsillectomy pain in children of 3-12 years old

Adenotonsillectomy is a common operation in children, which may have numerous complications after ansethesia. Postoperative pain is a serious complication that cause instability, rebleeding and other problems. Since the anesthesia method may affect the postoperative complications, the aim of this study was to compare the effects of atracurium and succinylcholine on post adenotonsillectomy pain in children. This clinical trial study was performed on eighty children of 3-12 years old who were candidate for adenotonsillectoy surgery. These children were subjected to two methods of general anesthesia. For muscle relaxation, atracurium was given to one group and succinylcholine to the other group. Using Oucher's test the severity of post operative pain was measured. Means of post operative pain [p<0.05] and heart rate [p<0.01] in succinyl group were more than those of atracurium group. However, rebleeding, hemmorage and vomiting after anesthesia were not significantly different between the two groups. Our results showed that the patients who were given atracurium had deeper anesthesia, less pain and were more comfortable than the other group

effect of teaching using, problem base learning and lecture on behavior, attitude and learning of nursing [BSc] students

Problem base learning results in the clarification of the words and concepts, the definition of the concepts, problem analysis, providing a systematic method to describe the situation during analysis process, the determination of learning objectives, getting more knowledge according to learning requirements and merging of the new knowledge with solutions. Regarding the progress of nursing science across the world and the importance of promotion in nursing education using new educational methods, the aim of this research was to determine the effect of teaching using both problem base learning and lecture on behavior, attitude and learning of nursing [BSc] students at Shahre-Kord university of medical science. This research was a semi-experimental study involved 40 of nursing [at 4[th] semester] students at Shahre-Kord university of medical sciences who were learning the internal course [surgery 2]. They were selected using conventional sampling method and divided into two equal groups of case and control, using random sampling method. The problem base learning and lecture methods were used to teach individuals of case and control groups, respectively. At the end of the course, using a questionnaire, behavior, attitude, and learning of the students were assessed. Using T and Manvitni tests, the data was analyzed. The students were 95% female and single. The mean of age in both groups was 22/04 +/- 1 years. There was no significant difference between the two groups in terms of the three former semester average scores, using t-test. The mean of learning in the case and control was 68.24 +/- 6.8 and 44.98 +/- 9.8, respectively. The mean of attitude in the case and control was 123.3 +/- 21 and 96.8 +/- 8 and the mean of behavior in the two groups was 69.5 +/- 2.5 and 63 +/- 3.1, respectively [p<0.001]. There was significant statistical difference [p<0.05] in the two categories of evaluation and application between the two groups studied [p<0.05]. There was also slight difference in the level of understanding between these two groups. Based on the results, teaching by problem base learning is more useful than lecture in modification and improvement of learning and attitude of the students studied. The results of this research is offered and recommended to the educational officials to substitute this method for the traditional ones

Use of herbal medicines by pregnant women in Shahr-e-Kord

Researchers have shown that herbal medicines are used by a large portion of pregnant women. Herbs are generally perceived as safe, harmless and free from side-effect but there have been reports on side-effects in pregnant mothers and their fetuses as well as on drug interactions. This study was undertaken to determine the prevalence of the use of herbal medicines among pregnant women referring to health care centers in Shahr-e-Kord. In this descriptive and cross-sectional study, 447 pregnant women, referring to health care centers and Hajar Hospital in Shahr-e-Kord, were interviewed while employing a structured questionnaire. The cases were chosen by simple random sampling. For the data analysis, student t-test and X[2] were used. In all, 51.9% of the pregnant women reported the use of herbal medicines during pregnancy. 91.7% of the women, had a positive attitude toward the use of herbal medicines during pregnancy, but 15% believed that the use of herbal medicines in pregnancy was unsafe. Among respondents, 55.9% had not reported the use of herbs to their physicians and the most common reasons for nondisclosure were the belief that herbal medicines were natural and safe [39.1%] and that doctors never asked about them [34.8%]. The most commonly reported uses of herbs were for common cold [29.1%], abdominal pain [17.4%] and induction of labor [11.7%]. Anchusa officinalis was the most commonly used herb among 55 other species of herbs. 74.2% of medicinal herb consumers cited family and relatives as their main source of information on the herbs. Factors associated with the use of herbal medicines in pregnancy were number of parities 1-3, monthly income more than 1,500,000 Rials and age 20-29, but none were statistically significant. There were significantly lower frequencies of herbal use in pregnancy among women with academic education [p=.004]. The widespread use of herbal medications and the positive attitude toward them during pregnancy, indicates an increased need to educate health-care providers on these issues to advise women not to expose themselves and their fetuses to the probable risks of herbal preparations