Iranian Red Crescent Medical Journal最新文献

Background: Despite the higher prevalence of overweight and obesity among young people in western countries, the 50th and 95th percentile ranks for waist circumference in the Iranian young Females are higher than those of the western ones.

Objectives: Identifying major dietary patterns in Iranian young females, which associate with central obesity, can probably explain the difference between Iranian young females' pattern and those of their western peers regarding obesity.

Patients and methods: In the current cross-sectional study, a total of 257 young females aged 11 - 15 years old from Talaat Intelligent Guidance School, Tabriz, Iran (2007) were selected for the study using non-probability simple sampling method. Then, usual dietary intakes of all subjects were evaluated by a food frequency questionnaire and anthropometric measurements such as weight, height, waist circumference, and Body Mass Index (BMI) using the standard protocols. Data were analyzed by inferential statistics (One-way ANOVA, Tukey test for Post-Hoc Analysis, Chi-square test, age-adjusted means, analysis of covariance with Bonferroni correction, correlation and partial correlation) by SPSS software.

Results: In the current study, six major dietary patterns were extracted using factor analysis method. Before and after controlling the age, subjects in the upper tertile of the Iranian Central Obesity Making Dietary Pattern (rich in cruciferous vegetables, green leafy vegetables, soft drinks, tomatoes, other vegetables and vegetable oils) had larger waist circumference in comparison with the ones in the lower tertile (before controlling for age: 64.2 ± 9 vs. 61.6 ± 7 P = 0.03; after: 64.5 ± 0.8 vs. 61.5 ± 0.8, P = 0.009). However in lacto vegetarian dietary pattern (rich in legumes, potato, other vegetables, dough, high-fat dairy products and margarine), individuals in the upper tertile had significantly lower weight, waist circumference and body mass index (BMI) in comparison with the ones in the lower tertile (weight: 44.9 ± 9.3 vs. 51.4 ± 10.6, P < 0.01; WC: 59.9 ± 8 vs. 64 ± 7.9, P < 0.01; BMI: 18.6 ± 3.1 vs. 20.6 ± 3.5, P < 0.01).

Conclusions: The current study findings suggest that the Iranian Central Obesity Making Dietary Pattern is directly associated with waist circumference (marker of central obesity), while lacto vegetarian dietary pattern is reversely associated with weight, waist circumference and BMI. Special obesity pattern in Iranian young females can be justified by Iranian Central Obesity Making Dietary Pattern".

Introduction: Substernal goiter may rarely cause superior vena cava syndrome (SVCS) owing to venous compression, and cause acute respiratory failure due to tracheal compression. Obstructive sleep apnea syndrome (OSAS) may rarely occur when there is a narrowing of upper airway by edema and vascular congestion resulting from SVCS.

Case presentation: We presented the clinical course and treatment of acute respiratory failure (ARF) developed in a patient with SVCS and OSAS due to substernal goiter. After treatment of ARF with invasive mechanical ventilation, weaning and total thyroidectomy were successfully performed through collar incision and median sternotomy without complications.

Conclusions: Our case showed that if the respiratory failure occurred due to substernal goiter and SVCS, we would need to investigate the coexistence of OSAS and SVCS.

Background: One of the strategies for a good outcome and pain free childbearing is to design the delivery room.

Objectives: The aim of this study was to evaluate the effects of snoezelen room on childbearing outcome such as pain intensity, duration of labor, and perinea status in nulliparous women.

Patients and methods: This study was a randomized controlled clinical trial consists of 100 childbearing women. They were randomly divided into 2 groups. The experimental group went to snoezelen room when their cervix dilation was 4 cm, while the control group went to physiologic delivery room with the same cervix dilation.

Results: The mean ± SD of VAS (Visual Analogue Scale) pain intensity of the experimental and control groups before the intervention were 5.1 ± 1.95 and 5.58 ± 1.62, respectively (P = 0.13). The mean ± SD of VAS pain intensity scores of the experimental and control groups after 3 hours spending in their assigned rooms were 5.26 ± 0.86 and 9.56 ± 1.48, respectively (P = 0.01). The mean ± SD of the first stage scores of the experimental and control groups were 6.95 ± 0.97 and 8.41 ± 0.67, respectively (P = 0.042). About 92% of participants' intervention vs. 66% of control participants had perinea laceration (P = 0.041).

Conclusions: According to the findings of the present study, distracting senses in snoezelen room decreases mother's pain intensity, the length of labor, and incidence of episiotomy.

Background: Human resource is the most important factor of performance, success and better revelation of excellence goals of each organization. By performing excellence plan, healthcare organizations improve their organizational climate and play a valuable role in retaining nurses and improving the quality of their services to patients.

Objectives: The aim of this study was to compare hospital organizational climate and intention to leave among working nurses in hospitals performing the excellence plan and other hospitals of Tehran University of Medical Sciences.

Patients and methods: This was a cross-sectional descriptive comparison study. Its population included 248 nurses of the hospitals performing the excellence plan and other hospitals of Tehran University of Medical Sciences in Iran selected by random sampling. The used instrument had three parts: the first part was related to personal characteristics, the second part was the Munn's organizational climate questionnaire and the third part was Hinshaw's questionnaire of "anticipated turnover scale". Data was analyzed using SPSS software, version 17 and indices of descriptive statistics and inferential statistics.

Results: The results of the mean and standard deviation for organizational climate and intention to leave in both performing and non-performing hospitals of the organizational excellence plan were respectively (65.28 ± 19.31 and 56.42 ± 21.36) and (33.64 ± 5.58 and 35.59 ± 4.94). Independent T test revealed a significant difference between the mean scores for organizational climate in both performing and non-performing hospitals, and also a significant difference between the mean scores for intention to leave in both performing and non-performing hospitals (P = 0.004). Moreover, Pearson Correlation test showed a reverse significant correlation between organizational climate and intention to leave in performing hospitals of the organizational excellence plan (r = -0.337) and non-performing hospitals (r = -0.282) (P = 0.001).

Conclusions: Performing quality improvement pattern such as organization's excellence plan improves organizational climate of healthcare sectors, it can reduce nurses' intentions to leave and retain human resources.

Introduction: Sclerosing encapsulating peritonitis (SEP) is characterized by partial or complete encasement of small intestine by a thick fibrocollagenous membrane. Depending on underlying causes, SEP is divided into primary and secondary forms. Idiopathic SEP is also called idiopathic or abdominal cocoon syndrome. Herein we presented a case of idiopathic SEP.

Case presentation: A 90-year-old male patient presented to our emergency department with signs and symptoms of intestinal obstruction and dehydration. Physical examination findings, patient's age and plain abdominal radiography were consistent with tumoral obstruction or viscus perforation. Explorative laparotomy revealed a fibrous capsule encasing intestines as well as dense adhesions between intestinal loops. Since the overall condition of the patient was not well enough to allow a wide dissection and membrane excision, the operation was terminated after performing a limited loop ileostomy. Unfortunately, the patient was lost due to organ failure at the postoperative period.

Conclusions: Despite advances in radiological techniques, the exact diagnosis in many cases is still made according to intraoperative findings and histopathological properties of the excised membrane. While some cases of SEP remain asymptomatic for years, most cases are characterized by recurrent bouts of acute, subacute or chronic intestinal obstruction. To our knowledge, the case presented here is the oldest patient with idiopathic SEP in the literature.