Shiraz E-Medical Journal Shiraz E-Medical Journal Shiraz E-Med J http://www.emedicalj.portal.tools 1735-1391 10.5812/semj. en jalali 2019 9 17 gregorian 2019 9 17 13 3
en Demographic Features of Patients in Methadone Maintenance Treatment, Referred To Private Mmt Clinic, Sari-Iran (2009-2010) Demographic Features of Patients in Methadone Maintenance Treatment, Referred To Private Mmt Clinic, Sari-Iran (2009-2010) research-article research-article Introduction

Addiction to opioids poses serious problems for communities, families, and individuals. Solutions sometimes seem uncertain, difficult, and controversial. Most of patients can not tolerate drug abstinence permanently and they continue to live through preparing and using drugs permanently if there is no method of maintenance treatment. Methadone Maintenance treatment (MMT) has become a major intervention in the care and treatment of drug dependence in many countries. Now MMT is used as a maintenance method in Sari and we decided to evaluate this method in addicted patients in private MMT clinic.

Method and Materials

This cross-sectional descriptive study was performed from April 2009 to April 2010 in all patients who have been referred for treatment to the private MMT clinic during this year. The tools for searching were epidemiologic questionnaire, patients file and interview. Collected data was analyzed using the descriptive statistics.

Results

Data collected from 200 patients were analyzed. Most patients (142 patients) were urban. 44 patients (22%) had finished high school and 36 (18%) had higher educa-tions. 155 patients use opium. 85 patients have treatment history of their addiction in recent years. 38 (19%) subjects had suspicious sexual relations. 67 (33.5%) cases had depression and 68 (34%) ones had aggressive behavior on the basis of DSM-IV criterion. 66 patients (33%) had full-time jobs.

Conclusion

This study shows the most common substance that use in Iran is still opium. And it uses in all range of ages. A large number of our patients had finished high school and higher education degrees. So it shows the importance of preventive strategies in society

Introduction

Addiction to opioids poses serious problems for communities, families, and individuals. Solutions sometimes seem uncertain, difficult, and controversial. Most of patients can not tolerate drug abstinence permanently and they continue to live through preparing and using drugs permanently if there is no method of maintenance treatment. Methadone Maintenance treatment (MMT) has become a major intervention in the care and treatment of drug dependence in many countries. Now MMT is used as a maintenance method in Sari and we decided to evaluate this method in addicted patients in private MMT clinic.

Method and Materials

This cross-sectional descriptive study was performed from April 2009 to April 2010 in all patients who have been referred for treatment to the private MMT clinic during this year. The tools for searching were epidemiologic questionnaire, patients file and interview. Collected data was analyzed using the descriptive statistics.

Results

Data collected from 200 patients were analyzed. Most patients (142 patients) were urban. 44 patients (22%) had finished high school and 36 (18%) had higher educa-tions. 155 patients use opium. 85 patients have treatment history of their addiction in recent years. 38 (19%) subjects had suspicious sexual relations. 67 (33.5%) cases had depression and 68 (34%) ones had aggressive behavior on the basis of DSM-IV criterion. 66 patients (33%) had full-time jobs.

Conclusion

This study shows the most common substance that use in Iran is still opium. And it uses in all range of ages. A large number of our patients had finished high school and higher education degrees. So it shows the importance of preventive strategies in society

Demographic Features;Drug Dependence;Methadone Demographic Features;Drug Dependence;Methadone 128 134 http://www.emedicalj.portal.tools/index.php?page=article&article_id=10198 Seyyed Hamzeh Hosseini Seyyed Hamzeh Hosseini Department of Psychiatry, Mazandaran University of Medical Sciences, Iran Department of Psychiatry, Mazandaran University of Medical Sciences, Iran Mehrdad Taghipour Mehrdad Taghipour Cancer Research Center, School of Medicine, Mazandaran University of Medical Sciences, Iran 989378351910, mehrdadtaghipour@gmail.com Cancer Research Center, School of Medicine, Mazandaran University of Medical Sciences, Iran 989378351910, mehrdadtaghipour@gmail.com Mehrdad Tavakkoli Mehrdad Tavakkoli School of Medicine, Mazandaran University of Medical Sciences, Iran School of Medicine, Mazandaran University of Medical Sciences, Iran Amir Hamta Amir Hamta Department of Psychiatry, Mazandaran University of Medical Sciences, Iran Department of Psychiatry, Mazandaran University of Medical Sciences, Iran
en Functional Ovarian Cysts: a Multicenter Study of the Current Management Among Iranian Patients Functional Ovarian Cysts: a Multicenter Study of the Current Management Among Iranian Patients research-article research-article Introduction

Ovarian cysts occur in 30% of females with regular menses, 50% of fe-males with irregular menses and 6% of postmenopausal females

Aim

In the present study we aimed to compare the actual practice with optimal practice in management of F.O.C. The aim of this study is to find out how many functional ovar-ian cysts are removed in studied gynecologic departments with the current practice

Materials and Methods

In a multi-centric study histopathology of benign ovarian in-volvements of patients coming to 20 hospitals were reviewed from 1998 to 2005. Age, sonographic findings and histopathology were recorded

Statistical analysis used

Analysis was done using SPSS software (Version 13, SPSS Inc., Chicago, Illinois, USA). Statistical analysis of the results were recorded as fre-quency, (mean + SD) and median (range).

Results

In 2981 patients with benign ovarian histopathology undergoing surgery, 1732 (58.5%) had functional ovarian cysts. Among patients with functional ovarian cyst, 1005 (58%) were uncomplicated, followed by 686 patients (39.6%) having hemorrhagic and 41 patients (2.3%) having torsed ovarian cyst

Conclusions

Our finding suggests more functional ovarian cysts might have avoided surgery, if more strict criteria for surgery were followed in gynecological departments.

Introduction

Ovarian cysts occur in 30% of females with regular menses, 50% of fe-males with irregular menses and 6% of postmenopausal females

Aim

In the present study we aimed to compare the actual practice with optimal practice in management of F.O.C. The aim of this study is to find out how many functional ovar-ian cysts are removed in studied gynecologic departments with the current practice

Materials and Methods

In a multi-centric study histopathology of benign ovarian in-volvements of patients coming to 20 hospitals were reviewed from 1998 to 2005. Age, sonographic findings and histopathology were recorded

Statistical analysis used

Analysis was done using SPSS software (Version 13, SPSS Inc., Chicago, Illinois, USA). Statistical analysis of the results were recorded as fre-quency, (mean + SD) and median (range).

Results

In 2981 patients with benign ovarian histopathology undergoing surgery, 1732 (58.5%) had functional ovarian cysts. Among patients with functional ovarian cyst, 1005 (58%) were uncomplicated, followed by 686 patients (39.6%) having hemorrhagic and 41 patients (2.3%) having torsed ovarian cyst

Conclusions

Our finding suggests more functional ovarian cysts might have avoided surgery, if more strict criteria for surgery were followed in gynecological departments.

Ovarian Cysts; Ultrasonography Ovarian Cysts; Ultrasonography 102 107 http://www.emedicalj.portal.tools/index.php?page=article&article_id=20527 Maliheh Arab Maliheh Arab Imam Hossein Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Imam Hossein Medical Center, Shahid Madani St.Tehran, Iran. , + 98-9121593277 Imam Hossein Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Imam Hossein Medical Center, Shahid Madani St.Tehran, Iran. , + 98-9121593277 Tahereh Ashrafganjoi Tahereh Ashrafganjoi Imam Hossein Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran Imam Hossein Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran Soghra Yagoubi Soghra Yagoubi Imam Hossein Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran Imam Hossein Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran Giti Noghabaee Giti Noghabaee Imam Hossein Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran Imam Hossein Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran Kourosh Sheibani Kourosh Sheibani Clinical Research and Development Center, Imam Hossein Medical Center, Shahid Beheshti Univer-sity of Medical Sciences, Tehran, Iran Clinical Research and Development Center, Imam Hossein Medical Center, Shahid Beheshti Univer-sity of Medical Sciences, Tehran, Iran
en Renal Failure and Subarachnoid Hemorrhage, A Rare Complication after Echis Carinatus Bite: from Southern Iran. Report of a Case Renal Failure and Subarachnoid Hemorrhage, A Rare Complication after Echis Carinatus Bite: from Southern Iran. Report of a Case case-report case-report

Subarachnoid hemorrhage is a rare complication after snake bite. Herein, we report A 63 year old lady with generalized tonic colonic convulsion due to Subarachnoid hemor-rhage after Echis Carinatus bite

Subarachnoid hemorrhage is a rare complication after snake bite. Herein, we report A 63 year old lady with generalized tonic colonic convulsion due to Subarachnoid hemor-rhage after Echis Carinatus bite

Snake Bite; Subarachnoid Hemorrhage; Echis Carinatus Snake Bite; Subarachnoid Hemorrhage; Echis Carinatus 141 143 http://www.emedicalj.portal.tools/index.php?page=article&article_id=20529 Mohammad Mahdi Sagheb Mohammad Mahdi Sagheb Section of Nephrology, Department of Internal Medicine, Shiraz University of Medical Sciences, Shiraz, Iran. Section of Nephrology, Department of Internal Medicine, Shiraz University of Medical Sciences, Shiraz, Iran. Maryam Sharifian Maryam Sharifian Department of Neurology, Department of Internal Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.; Department of Neurology, Shiraz University of Medical Sciences, Shiraz, Iran , +98-9177133608 Department of Neurology, Department of Internal Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.; Department of Neurology, Shiraz University of Medical Sciences, Shiraz, Iran , +98-9177133608 Maryam Moini Maryam Moini Section of Gastroenterology and Hepatology, Department of Internal Medicine, Department of Medi-cine, Shiraz University of Medical Sciences, Shiraz, Iran Section of Gastroenterology and Hepatology, Department of Internal Medicine, Department of Medi-cine, Shiraz University of Medical Sciences, Shiraz, Iran Ovies Salehi Ovies Salehi Cardiovascular Research Center, Shiraz University of Medical Sciences, Shiraz, Iran Cardiovascular Research Center, Shiraz University of Medical Sciences, Shiraz, Iran Amir Hossein Sharifian Amir Hossein Sharifian Student of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran. Student of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
en Epidemiology of Hepatitis C Virus Infection in ESRD Patients in Khuzestan Province, Iran Epidemiology of Hepatitis C Virus Infection in ESRD Patients in Khuzestan Province, Iran research-article research-article Background

Liver disease caused by hepatitis C virus (HCV) in patients with end-stage renal disease (ESRD) causes significant morbidity and mortality. The aim of this study was to determine the prevalence of HCV infection and its relationship in ESRD patients living in the province of Khuzestan, Iran.

Materials and Methods

In a cross sectional study from December 2010 to March 2011, entire of ESRD patients treated with hemodialysis (HD) or peritoneal dialysis (PD) in the Khuzestan province enrolled for the study. A standardized questionnaire was used to collect Social and demographic data including cause of ESRD and date of onset of PD or HD. Blood samples were tested for hepatitis C antibody (anti-HCV) by enzyme-linked immunosorbent assays (ELISA). The Research Center of Ahvaz Joundishapur University of Medical Sciences approved the study.

Results

In overall, 1117 ESRD patients were enrolled for the study. The prevalence of anti-HCV was 3.4 % (38 patients, 20 males with Mean age of 45.29 years and 18 fe-males with Mean age of 45.6 years). The most common Cause of ESRD in anti-HCV positive patients was high blood pressure in 45.4%, followed by, DM in 28.7%, and unknown in 13.9%. We din not find any association between both sexes (P = 0.06) and also between mean age of anti-HCV positive and negative patients (P = 0.59). There was a significant association between high blood pressure as cause of ESRD with anti-HCV positivity (0.033).

Conclusions

Although, the prevalence of HCV infection among ESRD patients has decreased in recent years, however it remains as a significant cause of viral hepatitis among these patients in Khuzestan province

Background

Liver disease caused by hepatitis C virus (HCV) in patients with end-stage renal disease (ESRD) causes significant morbidity and mortality. The aim of this study was to determine the prevalence of HCV infection and its relationship in ESRD patients living in the province of Khuzestan, Iran.

Materials and Methods

In a cross sectional study from December 2010 to March 2011, entire of ESRD patients treated with hemodialysis (HD) or peritoneal dialysis (PD) in the Khuzestan province enrolled for the study. A standardized questionnaire was used to collect Social and demographic data including cause of ESRD and date of onset of PD or HD. Blood samples were tested for hepatitis C antibody (anti-HCV) by enzyme-linked immunosorbent assays (ELISA). The Research Center of Ahvaz Joundishapur University of Medical Sciences approved the study.

Results

In overall, 1117 ESRD patients were enrolled for the study. The prevalence of anti-HCV was 3.4 % (38 patients, 20 males with Mean age of 45.29 years and 18 fe-males with Mean age of 45.6 years). The most common Cause of ESRD in anti-HCV positive patients was high blood pressure in 45.4%, followed by, DM in 28.7%, and unknown in 13.9%. We din not find any association between both sexes (P = 0.06) and also between mean age of anti-HCV positive and negative patients (P = 0.59). There was a significant association between high blood pressure as cause of ESRD with anti-HCV positivity (0.033).

Conclusions

Although, the prevalence of HCV infection among ESRD patients has decreased in recent years, however it remains as a significant cause of viral hepatitis among these patients in Khuzestan province

Hepatitis C Virus; End-Stage Renal Disease; Hemodialysis Hepatitis C Virus; End-Stage Renal Disease; Hemodialysis 135 140 http://www.emedicalj.portal.tools/index.php?page=article&article_id=20531 Seyed Seifollah Beladi Mousavi Seyed Seifollah Beladi Mousavi Section of Nephrology, Department of Internal Medicine, Emam Hospital, Ahwaz Jundishapur Uni-versity of Medical Sciences, Ahwaz, Iran Section of Nephrology, Department of Internal Medicine, Emam Hospital, Ahwaz Jundishapur Uni-versity of Medical Sciences, Ahwaz, Iran Eskandar Hajiani Eskandar Hajiani Division of Gastroenterology, Department of Internal Medicine, Emam Hospital, Ahwaz Jundishapur University of Medical Sciences, Ahwaz, Iran; Department of Internal Medicine, Faculty of Medicine, Jundishapur University of Medical Sciences, Ahvaz, Iran , +98-9161135191 Division of Gastroenterology, Department of Internal Medicine, Emam Hospital, Ahwaz Jundishapur University of Medical Sciences, Ahwaz, Iran; Department of Internal Medicine, Faculty of Medicine, Jundishapur University of Medical Sciences, Ahvaz, Iran , +98-9161135191 Fatemeh Hayati Fatemeh Hayati Section of Nephrology, Department of Internal Medicine, Emam Hospital, Ahwaz Jundishapur Uni-versity of Medical Sciences, Ahwaz, Iran Section of Nephrology, Department of Internal Medicine, Emam Hospital, Ahwaz Jundishapur Uni-versity of Medical Sciences, Ahwaz, Iran Seyed Jalal Hashemi Seyed Jalal Hashemi Division of Gastroenterology, Department of Internal Medicine, Emam Hospital, Ahwaz Jundishapur University of Medical Sciences, Ahwaz, Iran Division of Gastroenterology, Department of Internal Medicine, Emam Hospital, Ahwaz Jundishapur University of Medical Sciences, Ahwaz, Iran Aliakbar Shayesteh Aliakbar Shayesteh Division of Gastroenterology, Department of Internal Medicine, Emam Hospital, Ahwaz Jundishapur University of Medical Sciences, Ahwaz, Iran Division of Gastroenterology, Department of Internal Medicine, Emam Hospital, Ahwaz Jundishapur University of Medical Sciences, Ahwaz, Iran Seyed Mohammad Salehi Behbehani Seyed Mohammad Salehi Behbehani Section of Nephrology, Department of Internal Medicine, Emam Hospital, Ahwaz Jundishapur Uni-versity of Medical Sciences, Ahwaz, Iran Section of Nephrology, Department of Internal Medicine, Emam Hospital, Ahwaz Jundishapur Uni-versity of Medical Sciences, Ahwaz, Iran Abdorrahim Masjedi Zadeh Abdorrahim Masjedi Zadeh Division of Gastroenterology, Department of Internal Medicine, Emam Hospital, Ahwaz Jundishapur University of Medical Sciences, Ahwaz, Iran Division of Gastroenterology, Department of Internal Medicine, Emam Hospital, Ahwaz Jundishapur University of Medical Sciences, Ahwaz, Iran M Beladi Mousavi M Beladi Mousavi Section of Nephrology, Department of Internal Medicine, Emam Hospital, Ahwaz Jundishapur Uni-versity of Medical Sciences, Ahwaz, Iran Section of Nephrology, Department of Internal Medicine, Emam Hospital, Ahwaz Jundishapur Uni-versity of Medical Sciences, Ahwaz, Iran
en Comparison of Prevalence of Fatigue in Adult Diabetic Mellitus Patients with Healthy Population in Shiraz 2010 Comparison of Prevalence of Fatigue in Adult Diabetic Mellitus Patients with Healthy Population in Shiraz 2010 research-article research-article Background

Diabetes mellitus refers to a group of common metabolic disorders that share phenotype of hyperglycemia. Fatigue is one of complains of diabetic patients. Due to lack of available documents in the prevalence of fatigue in Iran, we decided to study prevalence of this problem in our diabetic patients and compare with normal population

Materials and Methods

This is a cross-sectional study that was done in Shiraz city (in south of Iran).Sample included 400 patients diagnosed with diabetes referred to Nader-kazemi diabetes health center and 400 healthy controls among patient’s attendance and health center staff, were matched in age and gender with patient group. Data was col-lected by using Iowa Fatigue Scale (IFS) questionnaire. This questionnaire consisted of 2 parts. Second part included 11 questions that evaluated level of fatigue. Its validity and reliability was confirmed. Data was analyzed by SPSS 15 by chi-square test and p< 0.05 was considered as significant level.

Results

223 (55.75%) patients reported fatigue and 96 (24%) had sever fatigue. Also in control group 94 (23.5%) persons had fatigue and 23 (5.75%) had sever fatigue and difference between two groups was statistically significant. Some demographic factors such as age, duration of disease and education had a significant linear relationship with fatigue.

Conclusions

Considering the severity of fatigue among diabetic patients and its relation with older age, higher educational level and duration of disease further recommended interventions specially in this group of patients with serious matters such as the use of better therapies, social work and rehabilitation, providing more facilities for assistance and treatment, mental health and … comes to action.

Background

Diabetes mellitus refers to a group of common metabolic disorders that share phenotype of hyperglycemia. Fatigue is one of complains of diabetic patients. Due to lack of available documents in the prevalence of fatigue in Iran, we decided to study prevalence of this problem in our diabetic patients and compare with normal population

Materials and Methods

This is a cross-sectional study that was done in Shiraz city (in south of Iran).Sample included 400 patients diagnosed with diabetes referred to Nader-kazemi diabetes health center and 400 healthy controls among patient’s attendance and health center staff, were matched in age and gender with patient group. Data was col-lected by using Iowa Fatigue Scale (IFS) questionnaire. This questionnaire consisted of 2 parts. Second part included 11 questions that evaluated level of fatigue. Its validity and reliability was confirmed. Data was analyzed by SPSS 15 by chi-square test and p< 0.05 was considered as significant level.

Results

223 (55.75%) patients reported fatigue and 96 (24%) had sever fatigue. Also in control group 94 (23.5%) persons had fatigue and 23 (5.75%) had sever fatigue and difference between two groups was statistically significant. Some demographic factors such as age, duration of disease and education had a significant linear relationship with fatigue.

Conclusions

Considering the severity of fatigue among diabetic patients and its relation with older age, higher educational level and duration of disease further recommended interventions specially in this group of patients with serious matters such as the use of better therapies, social work and rehabilitation, providing more facilities for assistance and treatment, mental health and … comes to action.

Fatigue; Diabetes; Prevalence; Shiraz city Fatigue; Diabetes; Prevalence; Shiraz city 94 101 http://www.emedicalj.portal.tools/index.php?page=article&article_id=20533 Negin Hadi Negin Hadi Community Medicine, Shiraz University of medical sciences, member of Neurosciences research center, member of Research center for psychiatry and behavioral sciences, Shiraz University of Medi-cal Sciences, Shiraz, Iran; Department of Community Medicine, Shiraz Medical School, Zand Avenue, Shiraz, Iran , +98-7112354431 Community Medicine, Shiraz University of medical sciences, member of Neurosciences research center, member of Research center for psychiatry and behavioral sciences, Shiraz University of Medi-cal Sciences, Shiraz, Iran; Department of Community Medicine, Shiraz Medical School, Zand Avenue, Shiraz, Iran , +98-7112354431 Zeinab Khademalhosseini Zeinab Khademalhosseini Shiraz University of Medical Sciences, Shiraz, Iran Shiraz University of Medical Sciences, Shiraz, Iran Mitra Khademalhosseini Mitra Khademalhosseini Family Medicine position, Shiraz, Iran Family Medicine position, Shiraz, Iran
en Hemodialysis without Ultra Filtration is more effective than with Ultra Filtration on Spirometry Parameters Hemodialysis without Ultra Filtration is more effective than with Ultra Filtration on Spirometry Parameters research-article research-article Aim

Respiratory dysfunction is one of the most common problems among patients with end stage renal disease (ESRD). The aim of the present study is to evaluate the effects of hemodialysis (HD) with and without ultra filtration on various parameters of pulmonary function test among these patients

Materials and Methods

one hundred sixty ESRD patients undergoing maintenance HD more than 3 months and without acute lung disease were included in the study. HD was done using Fresenius 4008B dialysis machines, synthetic dialyzer membranes, bicarbon-ate base dialysate and with zero to 1-4 lit ultra filtration rate during each session. Spi-rometry test was performed before and immediately after a 4-hour HD session and al-terations in spirometry parameters including forced expiratory volume in first second (FEV1), forced vital capacity (FVC) and maximal mid expiratory flow rate (MMEF) were determined and their relations with ultra filtration rate were analyzed.

Results

The most common causes of ESRD were hypertension in 65 (40.6 %) and dia-betes mellitus in 46 (27.7%). Three patterns in spirometry were found among our pa-tients; obstructive, restrictive and normal pattern in 20%, 35.6% and 44.4% respectively.There was a significant increase in FEV1, FVC and FEF 25-75% after dialysis (P < 0.001). But, the average rate of increment in FEV1 and FVC was higher in patients undergoing hemodialysis without ultra filtration versus ultra filtration and the difference was statistically significant (FEV1, P = 0.04 and FVC, P = 0.001).

Conclusions

According to the results of our study, spirometry parameters increase sig-nificantly after a session of HD but these increments were much more in patients under-going HD without ultra filtration.

Aim

Respiratory dysfunction is one of the most common problems among patients with end stage renal disease (ESRD). The aim of the present study is to evaluate the effects of hemodialysis (HD) with and without ultra filtration on various parameters of pulmonary function test among these patients

Materials and Methods

one hundred sixty ESRD patients undergoing maintenance HD more than 3 months and without acute lung disease were included in the study. HD was done using Fresenius 4008B dialysis machines, synthetic dialyzer membranes, bicarbon-ate base dialysate and with zero to 1-4 lit ultra filtration rate during each session. Spi-rometry test was performed before and immediately after a 4-hour HD session and al-terations in spirometry parameters including forced expiratory volume in first second (FEV1), forced vital capacity (FVC) and maximal mid expiratory flow rate (MMEF) were determined and their relations with ultra filtration rate were analyzed.

Results

The most common causes of ESRD were hypertension in 65 (40.6 %) and dia-betes mellitus in 46 (27.7%). Three patterns in spirometry were found among our pa-tients; obstructive, restrictive and normal pattern in 20%, 35.6% and 44.4% respectively.There was a significant increase in FEV1, FVC and FEF 25-75% after dialysis (P < 0.001). But, the average rate of increment in FEV1 and FVC was higher in patients undergoing hemodialysis without ultra filtration versus ultra filtration and the difference was statistically significant (FEV1, P = 0.04 and FVC, P = 0.001).

Conclusions

According to the results of our study, spirometry parameters increase sig-nificantly after a session of HD but these increments were much more in patients under-going HD without ultra filtration.

Hemodialysis Hemodialysis 108 112 http://www.emedicalj.portal.tools/index.php?page=article&article_id=20534 Esmaeil Idani Esmaeil Idani Section of Pulmonology, Department of medicine, Jundishapur University of Medical Sciences, Ahvaz, Iran Section of Pulmonology, Department of medicine, Jundishapur University of Medical Sciences, Ahvaz, Iran Seyed Seifollah Beladi Mousavi Seyed Seifollah Beladi Mousavi Section of nephrology, Department of Medicine, Jundishapur University of Medical Sciences, Ahvaz, Iran Section of nephrology, Department of Medicine, Jundishapur University of Medical Sciences, Ahvaz, Iran Hanieh Raji Hanieh Raji Section of Pulmonology, Department of medicine, Jundishapur University of Medical Sciences, Ahvaz, Iran; Department of Internal Medicine, Faculty of Medicine, Jundishapur University of Medical Sciences, Ahvaz, Iran , +98-9166005565 Section of Pulmonology, Department of medicine, Jundishapur University of Medical Sciences, Ahvaz, Iran; Department of Internal Medicine, Faculty of Medicine, Jundishapur University of Medical Sciences, Ahvaz, Iran , +98-9166005565 Bita Bitarafan Bita Bitarafan Jundishapur University of Medical Sciences, Ahvaz, Iran Jundishapur University of Medical Sciences, Ahvaz, Iran
en An Academic Medical Center: a Customized Strategy to Overcome the Shortcomings of Interns’ Ambulatory Education An Academic Medical Center: a Customized Strategy to Overcome the Shortcomings of Interns’ Ambulatory Education research-article research-article Purpose

This study aims at evaluating the medical faculty Interns' skills in ambulatory area both from their own perspectives and researchers’ observations, in order to diag-nose the causes of the problems and to recommend the right solution

Method

In this study (2010), 4 researchers and 45 Interns of the Imam Reza Academic Medical Center (IRAMC), Tabriz- Iran measured the Interns' abilities in ambulatory care setting from 9 disciplines based on 1335 patients visited and using a well-structured questionnaire covered those abilities based on the MD2000 curriculum of the Brown University. Ambulatory teaching process in each clinic was described according to various items and based on researchers’ direct observations of 45 sessions.

Results

forty six faculties visited 10293 patients during two-hour sessions in an ex-tremely varied range -two to five times- per week for a period of five months (439 ses-sions) in 9 visit rooms with about 160 square feet area. The teaching model in all clinics was Grand Stand model, and some important reasons of the Interns' imperfect ambula-tory education were distinguished: attending in a resident-centered venue just to observe those mostly follow-up, complex and referral cases; lack of engagement in the patients' visit process and not receiving any feedback. The level of the Interns' abilities was mostly low both from their points of view and researchers' observations. Significant differences upon 4 items were found.

Conclusions

We found "frenetic and chaotic pace “of patient visit in IRAMC as the key constraint on ambulatory teaching, and in order to augment the Interns' unsatisfactory skill level, several customized recommendations would be presented

Purpose

This study aims at evaluating the medical faculty Interns' skills in ambulatory area both from their own perspectives and researchers’ observations, in order to diag-nose the causes of the problems and to recommend the right solution

Method

In this study (2010), 4 researchers and 45 Interns of the Imam Reza Academic Medical Center (IRAMC), Tabriz- Iran measured the Interns' abilities in ambulatory care setting from 9 disciplines based on 1335 patients visited and using a well-structured questionnaire covered those abilities based on the MD2000 curriculum of the Brown University. Ambulatory teaching process in each clinic was described according to various items and based on researchers’ direct observations of 45 sessions.

Results

forty six faculties visited 10293 patients during two-hour sessions in an ex-tremely varied range -two to five times- per week for a period of five months (439 ses-sions) in 9 visit rooms with about 160 square feet area. The teaching model in all clinics was Grand Stand model, and some important reasons of the Interns' imperfect ambula-tory education were distinguished: attending in a resident-centered venue just to observe those mostly follow-up, complex and referral cases; lack of engagement in the patients' visit process and not receiving any feedback. The level of the Interns' abilities was mostly low both from their points of view and researchers' observations. Significant differences upon 4 items were found.

Conclusions

We found "frenetic and chaotic pace “of patient visit in IRAMC as the key constraint on ambulatory teaching, and in order to augment the Interns' unsatisfactory skill level, several customized recommendations would be presented

Ambulatory Education; Intern; Shortcoming; Clinical Skill Ambulatory Education; Intern; Shortcoming; Clinical Skill 113 121 http://www.emedicalj.portal.tools/index.php?page=article&article_id=20535 Saeideh Ghaffarifar Saeideh Ghaffarifar Research Center of Medical Education, Tabriz University of Medical Sciences, Tabriz, Iran; Department of Health Education, School of Medicine, Tarbiat Modares University , + 98- 9128120191 Research Center of Medical Education, Tabriz University of Medical Sciences, Tabriz, Iran; Department of Health Education, School of Medicine, Tarbiat Modares University , + 98- 9128120191 Morteza Ghojazadeh Morteza Ghojazadeh Department of physiology, Research Methodology Consultant of Research and Development Coordi-nation Centre, Tabriz University of Medical Sciences, Tabriz, Iran Department of physiology, Research Methodology Consultant of Research and Development Coordi-nation Centre, Tabriz University of Medical Sciences, Tabriz, Iran Mahasti Alizadeh Mahasti Alizadeh Department of Family and Community Medicine, Tabriz University of Medical Sciences, Tabriz, Iran Department of Family and Community Medicine, Tabriz University of Medical Sciences, Tabriz, Iran Mohammad Reza Ghaffari Mohammad Reza Ghaffari Department of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran Department of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran Fatemeh Sadeghi-Ghyassi Fatemeh Sadeghi-Ghyassi Iranian Center for Evidence-Based Medicine, Tabriz University of Medical Sciences, Tabriz, Iran Iranian Center for Evidence-Based Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
en Assessing Death Anxiety and its Correlates Among Severe Medically Ill in- Patients Assessing Death Anxiety and its Correlates Among Severe Medically Ill in- Patients research-article research-article Introduction

In spite of the certainty of reality of death, people seem unable to escape anxiety at the prospect of them. Death anxiety contributes to important emotional and behavioral consequences. The aim of this study is to investigate relation of death anxiety with variable such as severity of illness, depression and religious belief.

Patients and Methods

The study is a cross-sectional, descriptive study. Data were collected using demographic questionnaire, templar death anxiety scale, beck depression questionnaire, cumulative illness rating scale and religious attitude questionnaire. The co relational and regression analysis were conducted to identify the factors that correlate and predict the level of death anxiety respectively.

Result

A group of hundred and fifty persons including 50 severely ill patients, 50 relative caregivers and 50 normal healthy controls completed the questionnaires. Death anxiety score was 7.2 relatives, 5.3 in patients and 4.4 in control group. Depression and severity of illness had positive correlation with death anxiety in medical patients (P < 0.05).in addition to that religious belief had negative correlation with death anxiety (P < 0.05) and was the strongest protective factor for death anxiety in patients group. In relatives and controls depression predicted more death anxiety.

Conclusion

Individuals suffering from Sever medical illnesses do not inevitably experience more death anxiety. Discussing to the relative the fact, the low death anxiety in their relative patients, will preserve the right of patients to make rational decision about their treatment and life. In presence of death anxiety early detection and management of depression could reduce death anxiety.

Introduction

In spite of the certainty of reality of death, people seem unable to escape anxiety at the prospect of them. Death anxiety contributes to important emotional and behavioral consequences. The aim of this study is to investigate relation of death anxiety with variable such as severity of illness, depression and religious belief.

Patients and Methods

The study is a cross-sectional, descriptive study. Data were collected using demographic questionnaire, templar death anxiety scale, beck depression questionnaire, cumulative illness rating scale and religious attitude questionnaire. The co relational and regression analysis were conducted to identify the factors that correlate and predict the level of death anxiety respectively.

Result

A group of hundred and fifty persons including 50 severely ill patients, 50 relative caregivers and 50 normal healthy controls completed the questionnaires. Death anxiety score was 7.2 relatives, 5.3 in patients and 4.4 in control group. Depression and severity of illness had positive correlation with death anxiety in medical patients (P < 0.05).in addition to that religious belief had negative correlation with death anxiety (P < 0.05) and was the strongest protective factor for death anxiety in patients group. In relatives and controls depression predicted more death anxiety.

Conclusion

Individuals suffering from Sever medical illnesses do not inevitably experience more death anxiety. Discussing to the relative the fact, the low death anxiety in their relative patients, will preserve the right of patients to make rational decision about their treatment and life. In presence of death anxiety early detection and management of depression could reduce death anxiety.

Death anxiety;Severe Medical Patients;Correlates Death anxiety;Severe Medical Patients;Correlates 122 127 http://www.emedicalj.portal.tools/index.php?page=article&article_id=12467 Marjan Anvar Marjan Anvar Department of Psychiatry, Shiraz University of medical sciences, Shiraz, IR Iran. Department of Psychiatry, Shiraz University of medical sciences, Shiraz, IR Iran. Ali Javadpour Ali Javadpour Research centre for psychiatry and behavioural sciences, 6 shiraz university of medical sciences, shiraz, IR Iran Research centre for psychiatry and behavioural sciences, 6 shiraz university of medical sciences, shiraz, IR Iran Sahand Mohammad Sahand Mohammad