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Introduction: Cecal volvulus is an emergency surgical acute abdomen. In this condition cecum, ileum terminal and ascending colon becomes twisted on its mesenteric anticlock wise direction rotation ranging 180-360 degrees. The cecal volvulus is caused by a lack of fixation of cecum to retroperitoneum. The usual presentation consists of severe colicky abdominal pain with asymmetric abdominal distension. In this article two cases of cecal volvulus are presented. Cases: The first case was a 74 year old female which presented with sudden abdominal pain & asymmetrical severe distension following 3 days constipation. After Plain abdominal x-ray and abdominal CT scan, right hemicolectomy was performed. The second case was a 70 year old female who following 4 days constipation was presented with abdominal pain and distension. Supine and erect abdominal x-ray showed colon hyperaeration and multiple air-fluid levels. The gangrenous colon was resected and colostomy was done. Conclusion: Despite other causes of intestinal obstruction or sigmoid volvulus which can sometimes be treated medically, the treatment of cecal volvolus is always surgery and consisted of cecum and ascending colon resection.

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Abstract Background: Side effects of drugs were increased with intractable consumption and this fact is more important in women during pregnancy and lactation period. The aim of this study has been determined the effect of education based on Health Belief Model on self-medication in mothers referring to health centers of Arak. Materials and Methods: In this clinical trial study, 300 mothers referring to health centers of Arak were participated. Data were collected with a questionnaire based on Health Belief Model and a performance checklist about drugs intractable consumption. Before educational intervention, questionnaires and checklists for both groups were completed and then intervention was done during 1 month in 4 sessions, 60 minutes. Data again were collected and then analyzed 3 month after intervention in both groups. Results: Before educational intervention, the rate of knowledge, perceived susceptibility, severity, and benefit of self medication were in the mediate level and the mother's performance about drug intractable consumption were more than mediate. After educational intervention, between two groups had significant difference in all variables and mothers performance in self-medication was reduced (p<0.05). Conclusion: By increasing in mean score of Health Belief Model parts, including: knowledge, perceived susceptibility, severity, and benefit, performance in field of self-medication was reduced. Recommended, training based on this model carried out in other health centers for reducing drugs intractable consumption.

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Abstract Background: Over 2 billion world people suffer from iron deficiency. Teenager girls are one of vulnerable groups in this area. Health education with various methods is a suitable tool for motivating and modifying incorrect function. The purpose of this research was determining the effect of health education program base on PRECEDE Model for controlling iron- deficiency anemia. Materials and Methods: This quasi-experimental and two-phase study was done on 72 students placed into case and control groups in 2007-8. Intervention was done in three sections with 45 minutes and 3 months after educational intervention was followed. Questionnaire base on PRECEDE Model parts and blood lab exams (Hb, Hct, Feritin) were data gathering tool. Data were analyzed by pair T- test, independent T- test, Mann- Whitney and Chi- square tests. Results: The mean score of knowledge (p<0.001) and attitude (p<0.001) (Predisposing factors), Using educational resources, taking place educational class and participating in educational programs (Enabling factors), encourage family and teachers (Reinforcing factors) and iron deficiency anemia preventive behaviors had a significant increase in the case group after the educational intervention. Conclusion: Above results indicate positive effect of educational intervention program base on PRECEDE Model and main components (Predisposing, Enabling, Reinforcing factors) in improving of iron deficiency anemia preventive behaviors in the study population.

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Background: Adolescents, as a large age group in the world, face many physical, mental and social problems in their puberty period. Health education proper to their needs and through new educational methods is of great importance. This study mainly aims to examine the impact of peer education approaches on girls' performance regarding pubertal physical health. Materials and Methods: In this experimental study, through random sampling, 100 female pupils were divided into two groups of experimental (n=50) and control (n=50). The self-made questionnaire, employed in this study, was based on peer approach. After 1.5 months, the participants' performance was evaluated through the post-test and compared to the pre-test results for the two groups. Scoring was conducted out of 100 and the scores under 50 indicated weak performance, those between 50 and 75 showed an average performance while scores above 75 indicated good performance. Results: Peer based educational approaches improved adolescent girls physical health. Statistical tests also revealed a significant difference between the mean of awareness and practice score in the two groups (p<0.001). Conclusion: Peer education methods result in the empowerment of adolescents, the provision of opportunities for them to participate in activities, and the improvement of communication between mothers and their daughters.

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Background: Nowadays, mothers have ceased to breastfeed due to several factors and resort to bottle-feeding or other forms of complementary feeding for their children. This results in physical and emotional problems for children, and socio-economic harms in communities. The aim of this study is to assess the impact of BASNEF model based education on successful breastfeeding in pregnant mothers referring to health centers in Arak. Materials and Methods: This quasi-experimental study was carried out with the participation of 88 pregnant women. The participants were randomly allocated to interuention and control groups. Instructions were given in four sessions on the basis of BASNEF model and behavioral objectives. Eventually, the collected data were analyzed by using statistical tests. Results: Mean scores of knowledge, attitude, enabling factors and subjective norms in the inerurntion group before and after education showed a significant difference in comparison with control group (p<0.001). Conclusion: Model-based education has positive impacts on behavior improvements. Thus, in health programs instead of applying traditional instructions, appying planned education programs based on health education models that have measurable and reliable effects is suggested.

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Background: Due to concerns over the negative impacts of PCB compounds on environment and their persistence, their production, use, and import has been banned in some countries. More recently, the Chemical Treaty on Persistent Organic Pollutants (POPs) has listed PCBs among priority chemicals for eventual elimination by 2025. The aim of this study was to determine the effect of solvents on the photodegradation of askarel oils using photolysis for reducing their hazards. Materials and Methods: The photochemical reactor, used in this experimental trial, was based on photolysis through UV/ H2O2 with a 500 ml beaker and low-pressure mercury lamp with a wavelength of 254 nm. The lamp was immersed in the beaker. The temperature and PH of the samples were constantly monitored. The experiments were repeated three times. Askarel oils were analyzed by GC/ECD. Results: The means of degradation of total PCBs due to the use of lamp for ethanol solvent and isooctane were 88% and 77%, respectively. The mean degradation of total PCBs in terms of the applied solvent ratio to the oil transformer for 1:1, 2:1, and 3:1 values for ethanol and isooctane were 55%, 85%, and 88%, and 40%, 77%, and 78%, respectively. Conclusion: Photolysis of PCB compounds in the presence of ethanol solvents, isoocatnes with strong oxidants such as H2O2, indicated their degradation or reduction in oil transformers with lower energy, and no yield of toxic byproducts. There was a significant difference in the employment of ethanol solvent and isooctane in degradation of askarel oil.

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Background: Hospital wastewater usually contains pathogenic micro-organisms, drugs, radio active materials, and toxic chemical elements that in case of being disposed without filtration, will result in pollution and spread of diseases. Therefore, evaluating the status of wastewater disposal in hospitals is necessary for proper planning. Materials and Methods: In a cross-sectional descriptive study in 2008, data collection was done by means of interviews, observations, and questionnaires in all hospitals of Markazi Province. Noticing the 33 items in the questionnaire, the overall conditions of the hospitals and the methods of using the sewage system were studied, and at the same time, filtration installations and wastewater disposal systems were inspected. Results: Of all the 19 hospitals, 10 used a conventional method of direct disposal of sewage to subterranean shafts, and of the 4 hospitals with filtration installations, three were practically out of order or were not efficient. Five of the hospitals were directly linked to the city sewage system without any pre-filtration. None of the hospitals had a specialized operator of sewage filtration and disposal system. Conclusion: Wastewater disposal in hospitals of Markazi Province is not desirable therefore, such acts as conducting more specific surveys, creating a positive attitude in planners, and providing sufficient funds for filtering wastewater in some of the hospitals are suggested.

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Background: In the last few decades, quality of life (QOL) has become known as an important concept in medical research. In this study, two standard QOL questionnaires were chosen for evaluation of patients’ personality characteristics: 1) World Health Organization Quality of Life (WHOQOL) and 2) Iranian Diabetics Quality of Life (IRDQOL). The main aim of this study was to compare two standard quality of life questionnaires for evaluation of the relationship between personality characteristics and glycemic control in diabetic patients. Materials and Methods: This cross-sectional study was carried out on 256 type 2 diabetic patients with a history of diabetes for more than one year. Validity and reliability measures were determined for the two questionnaires. HbA1c was measured through calorimetric method. Results: The mean of physical dimension scores on IRDQOL questionnaire was significantly lower than that on the WHOQOL questionnaire. No significant differences were observed between the other dimensions of the two questionnaires. Positive correlations were seen between different dimensions of each questionnaire. There was a high correlation between the different dimensions of each questionnaire and its related QOL. The two questionnaires did not indicate any correlations between glycemic control and different dimensions of QOL. Conclusion: The two questionnaires have reliability for the total QOL however, the distribution of questions in IRDQOL is not equal. The quality of the evaluation of patients’ personality characteristics by IRDQOL is less than that of WHOQOL. None of the questionnaires indicated any relationship between personal characteristics and glycemic control.

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Background: The consumption of hydrogenated vegetable oils, rich sources of both saturated fatty acids and trans fatty acids, is one of the most important risk factors for cardio-vascular diseases(CVD). The aim of this randomized semi-experimental control study was to modify the consumption habits of vegetable oils among families under the cover of health centers of Khomeini city. Materials and Methods: 136 adult women living in Khomein and Mohallat were randomly allocated to case and control groups. Data gathering instrument was a questionnaire based on PRECEDE framework. The educational intervention was weekly conducted in three 60-90 minute sessions based on the PRECEDE framework constructs for two months. Results: Mean scores of predisposing (knowledge and attitude), reinforcing, and enabling factors showed a significant difference in the case group in comparison to the control group(p<0.05). Also, hydrogenated vegetable oils consumption in case group decreased from 72% to 63% , whereas liquid vegetable oils consumption increased from 28% to 37%(p<0.05). Conclusion: Planning and implementation of an educational intervention program based on PRECEDE framework can be effective in reduction of hydrogenated vegetable oils consumption.

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Background: Trauma noise is one of the major physical pollutants in modern societies. Sound conditioning, on the other hand, is known as one of the mechanisms for protecting the hearing system. Materials and Methods: In this experimental study, 15 three month-old male white New Zealand rabbits were divided into three groups. The equipments used in this study included a sound generator, a loudspeaker, an exposure box, a sound level meter, and a distortion product otoacoustic emission (DPOAE) device. The rabbits were assigned to trauma noise exposure, conditioning noise exposure, and control groups. The conditioning and traumatic sound levels were respectively 80 and 105dB within the 500-3000 Hz frequency. Results: Conditioning noise at the level of 80 in combination with trauma noise enhanced the rabbits hearing system tolerance up to 13-17 dB so that in all frequencies there were significant differences between the trauma noise exposure group and the sound conditioning and trauma noise conditioning group (P<0.05). Conclusion: Sound conditioning can act as an effective factor in protecting the hearing system against trauma noise.

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Background: The purpose of this study was to identify the effect of health education according to health belief model (HBM) on the adoption of preventive behaviors of infection with giardia lamblia by primary school students in Arak. Materials and Methods: In a randomized quasi-experimental case study, 1200 students were randomly divided into two equal groups of test (instruction) and control (non-instruction). The sample size for giardiosis identification tests included 300 students, who had been equally and randomly selected from the control and test groups. Health education was according to HBM and its impact on the students' lifestyle-related patterns of behavior was considered. Results: Paring nails in the test group, significantly increased after education while it decreased significantly in the control group. The number of students who carried a glass for drinking slightly increased, but it remarkably decreased in the control group. The number of students who applied soap after using the restrooms remarkably increased in both the test and control groups. The relationship between not paring nails and infection with giardia lamblia was statistically significant. Additionally, after education, the ratio of reduction of infection with giardia lamblia in the test group to its increase in the control group was statistically significant. Conclusion: Preventive behaviors significantly improved and appeared influential in the reduction of infection with giardia lamblia. Thus, using a HBM in prevention of parasitic infections along with instructing the parents are suggested for prevention of parasitic infections.

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Background: Old, obese, and sedentary individuals are at risk for diabetes and cardiovascular diseases. Exercise improves metabolic anomalies associated with such diseases, but the effects of caloric restriction in coupled with exercise on such high- risk groups are not known. The aim of this study was to evaluate the effects of a 12 week lifestyle modification program on C- reactive protein and metabolic syndrome parameters in middle-aged obese/overweight men. Materials and Methods: In this experimental study with pretest – posttest design, 21 sedentary men were randomly assigned to 12- week caloric restriction (CR) [~500kcal] (age: 45.59± 4.90, BMI: 30.02± 1.73, CR, n=10) or exercise+caloric restriction group (EX+CR) [~500kcal] (age: 45.23± 5.6, BMI: 29.84± 1.60, EX+CR, n=11). Body composition, cardiovascular risk markers, and C- reactive protein were measured pre and post intervention. Results: After 12 weeks of intervention, significant reduction in body weight, abdominal fat (visceral, subcutaneous), insulin resistance, blood lipid profile, and C- reactive protein were observed in EX+CR group (P>0.05), Whereas, in CR group only significant improvement were observed in body weight and insulin resistance index (P>0.05). Conclusion: Lifestyle interventions incorporating diet to exercise improve insulin resistance, systemic inflammation, and other cardiovascular risk factors in middle-aged obese/overweight men.

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Background: The effects of acute and chronic exercises on insulin resistance index may be related to one or more factors, including morphological changes and hormonal modifications. The purpose of this study was to investigate the effects of a single session of resistance training on adiponectin levels and insulin resistance until 24 hours post-exercise. Materials and Methods: This experimental study, which followed a pretest-posttest design, was conducted on a group of 10 healthy male volunteers (23±1.4 years) with no history of participation in any regular exercise programs, weight changes more than 2 kg, special diseases, and smoking over the past 6 months that had normal body mass index (BMI) (23.7±1.6 kg.m-2). The subjects performed a single session resistance training (3 sets of 10 repetitions at 75% of 1 repetition maximum). Adiponectin, glucose, insulin, and insulin resistance index levels were measured before and 24 hours after the exercise. Results: There were no significant differences for adiponectin (μ g.ml-1) pre- (6.98±1.9) and post-exercise (8.07±1.4) and glucose (mg.dl-1) pre- (81.3±7.6) and post-exercise (80.7±6.4). However, insulin resistance index pre- (1.34±0.27) and post-exercise (1.06±0.11) and insulin concentration (UΙμ.ml-1) pre-(6.64±0.88) and post-exercise (5.37±0.43) decreased significantly 24 hours post-exercise (P<0.05). Conclusion: Based on the findings of this study, it can be suggested that a single session of resistance training with no significant changes in adiponectin level can have positive effects on glycemic indices in sedentary men.

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Background: Self-medication is one of the existing problems in the treatment cycle of patients that with aging and increased drug use, its side effects increase. The purpose of this study was to assess the factors influencing self-medication among elderly urban centers in Zarandieh based on Health Belief Model Materials and Methods: This descriptive cross-sectional study was conducted on 180 elderly individuals (95 females and 85 males) over 60 in Zarandieh. Data collection tools were a questionnaire designed based on HBM model (perceived susceptibility/ severity, and perceived benefits/barriers) and self-medication checklist. Results: The prevalence of self- medication in the elderly was 31% (33% women and 29% men). The most common reasons for self-medication were previous experience of the disease and its recognition (61%), availability of drugs (60.5%), and good result of their previous treatment (56.7%). There was a significant difference in awareness, sensitivity, severity, perceived benefits and barriers among people with or without self-medication history (P< 001). Conclusion: Noticing the side effects of drugs and the high prevalence of self-medication among elderly, designing educational programs for changing the awareness and beliefs of elderly regarding self-medication is recommended.

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Background: Aquatic ecosystems pollution with heavy metals, especially mercury, has always been a major concern for aquatic organisms health. Hence this study not only described an innovative method for analyzing organic mercury compound, but also evaluated total and organic mercury concentrations in great cormorant and compared them with world health standards. Materials and Methods: In this cross-sectional study, 18 great cormorants were randomly captured in March, 2009. Total and organic mercury of muscle, kidney, and liver tissues were analyzed by an advanced mercury analyzer made in the United States (Model Leco, AMA 254), and statistical analysis was done by Mann-Whitney U, and Kolmogrove-Smirnov tests. Results: Mean accumulated total mercury in liver, kidney, and muscle tissues were 5.67, 3.59, and 2.26 mg kg -1 w.w., respectively and organic mercury formed 82, 79, and 58 % of the total mercury. Conclusion: The levels of accumulated mercury in all tissues of great cormorant were more than the established limits by WHO, FAO, and EPA. These results can be a serious warning for consumers of these birds, especially vulnerable people.

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Background: Brucellosis is a major zoonotic disease with worldwide distribution. The prevalence of this disease has decreased in developed countries however, in developing countries, it is still prevalent. The aim of study was to determine the effect of a health belief model (HBM) based educational program on the empowerment of rural women in Zarandieh in prevention of brucellosis. Materials and Methods: In a quasi-experimental study with a pre-test/post-test design, 141 rural women were randomly selected and assigned to experimental and control groups. The educational program was implemented for the experimental group. Data were gathered by a researcher-made questionnaire and analyzed by SPSS software version 16. Results: Demographic variables of the two groups were similar before education. In addition, there were no significant differences between the experimental and control groups with regard to mean knowledge, HBM constructs, and performance however, the post-test revealed significant differences in terms of the mean of variables between the two groups (P<0.001). Conclusion: The HBM based educational program is effective in women’s empowerment and also promoting women’s beliefs and performance regarding brucellosis therefore, the findings of this study may be used as a framework in designing zoonotic diseases prevention programs

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Background: Physiological studies suggest that sleep deprivation may influence bodyweight through affecting appetite (decreasing leptin and increasing ghrelin). The aim of this study was to evaluate the effects of 12 weeks of aerobic training on obesity indices, serum levels of ghrelin and leptin, and sleep quality in overweight and obese men. Materials and Methods: In this quasi-experimental study, 22 overweight and obese men with low sleep quality were randomly assigned to aerobic training (n=12) and control (n=10) groups. Aerobic training was performed (50-60 min/day, 3 day/week) for 12 weeks. Serum ghrelin and leptin and obesity and sleep quality indices were measured before and after the intervention. Changes in dependent variables resulting from the training intervention were assessed by dependant t-test using SPSS software. Results: After aerobic training, weight (p<0.03), body mass index (p<0.04), visceral fat (p<0.04), total abdominal fat (p<0.03), and sleep quality (p<0.001) significantly improved. However, ghrelin and leptin serum levels did not change in response to aerobic training (p<0.05) during the same period. Conclusion: Short-term aerobic training improved obesity indices and sleep quality in obese/overweight men, yet this improvement was not accompanied by changes in ghrelin and leptin serum levels.

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Background: A lot of research has been done on the post-traumatic stress, but few studies have investigated the effect of chronic stress disorders on physical and psychological health. This study investigated the combined interactive effects of chronic stress disorders and mental disorders on somatoform disorders reporting among employees at Isfahan Steel Company. Materials and Methods: In this correlational study, 189 employees in Isfahan Steel Company wwere selected according to the stratified random sampling method and completed demographic characteristics, chronic stress disorders of Cohen, Karmark, and Mermelstein, and mental disorders and somatoform disorders of Barling, Loughlin, and Kelloway questionnaires in 2011. Data were analyzed using Pearson correlation coefficient and hierarchical regression. Results: Results showed significant internal correlations among chronic stress disorders, mental disorders, and somatoform disorders (p<0.01). In addition, by controlling for demographic variables, the results of hierarchical regression analysis showed the interactive effect of chronic stress disorders and mental disorders on reporting somatoform disorders to be significant (p<0.05). Conclusion: This study showed that chronic stress disorders have a positive relationship with reporting somatoform disorders both in experiencing and not experiencing psychological disorders however, this relationship was stronger when employees in addition to chronic stress disorders experienced psychological disorders.

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Background: Cutaneous leishmaniasis is a health problem in many areas of Iran. Cutaneous leishmaniasisis reported mostly in the central county of Qom province, including Ghanavat and Qomrood villages. This study was done to identify parasite species in human and rodents in order to illustrate the epidemiologic picture of the disease and provide an appropriate control program in 2010 Materials and Methods: This cross-sectional study was done on microscopic smears of 45 human samples and rodents samples hunted around Ghanavat and Qomrood villages in the central county of Qom province in 2010.In total,15 human samples and one hunted rodent sample were positive. In this study,the DNA of the parasites were extracted from the slides and analyzed by Leishmania specific premiers using ITS1 PCR-amplification (Internal Transcribed Spacer1). PCR (PolymeraseChain Reaction) products were digested by Haelll enzyme. Results: Overall, 15 human samples and one rodent sample from Merioneslibycus species were evaluated by PCR-RFLP (Restriction Fragment Length Polymorphism). After electrophoresis, it was demonstrated that the parasite was Leishmaniamajor in both human and rodent species. Conclusion: PCR-RFLP technique is an effective method to determine Leishmania parasite species in Geimsa stained slides from human and rodent reservoirs. One of the advantages of this technique is that it is possible to recognize the pathogen species of Leishmania parasite without gene sequencing. Besides, PCR-RFLP technique is a method of quite high sensitivity and specificity which can identify parasite species in addition to the diagnosis of leishmaniasis within 24 hours.

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Background: Considering the lack of a standardized and validated questionnaire on oral health care for pregnant women based on a specific behavioral pattern, the aim ofthis study was development and psychometric assessment of an oral health instrument based on Health Belief Model in pregnant women. Materials and Methods: This cross-sectional study was carried out on 340 pregnant women in Arak city. After reviewing the related literature, the instrument was designed and its content validity ratio, content validity index, face validity, and exploratory factor analysis were measured. For measuring the reliability of the scales, three methods, including test-retest, internal consistency, and agreement, were used. Data analysis was done using SPSS software. Results: The reliability of the 61 items was evaluated with impact score of 1.5 and the content validity index of 0.79 and based on exploratory factor analysis were classified into seven categories. The overall reliability measured through Cronbach alpha was 0.84. The reliability of the questionnaire was 0.88, perceived susceptibility was 0.73, severity was 0.70, perceived benefits was 0.75, perceived barriers was 0.71, the cues to action was 0.72, and self-efficacy was 0.76. Kappa coefficients were determined with a high performance for checklists. Conclusion: This study provided good evidence of the strength factor structure and reliability of Health Belief Model structures about oral health behaviors in the vulnerable group of pregnant women, according to the study of psychometrics process.