BackgroundType II diabetes and its complications impose a large economic burden on health care systems. This study aims to assess the effectiveness of educational intervention based on extended health belief model on type 2 diabetic patients.Methods120 patients with type II diabetes referring to randomly selected hospitals of Tehran University of Medical Sciences were enrolled in this educational intervention study. Patients were randomly divided into two groups (intervention and control). Data were collected using a questionnaire including demographic information and extended health belief model constructs. Two face to face educational sessions were conducted for each patient. Data were collected in two groups at three stages of the study; before the educational sessions and at 3 months and 6 months intervals. Analysis was performed by SPSS (17.0) and STATA (11.0) using independent T-test, Chi-square, Fisher’s exact test, analysis of covariance and Generalized Estimating Equation. A p value of less than 0.05 was regarded as statistically significant.ResultsThe educational program had a positive and significant impact (p < 0.0001) on extended health model belief constructs (including perceived susceptibility, perceived intensity, perceived benefits, perceived barriers and self-efficacy) in experimental group, 3 and 6 months after the intervention.ConclusionsThe results of this study showed the importance of extended health belief model based education in improving the model constructs and increasing self-efficacy in patients with type-2 diabetes.

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IntroductionLead is a heavy metal to which people are commonly exposed. One of the possible mechanisms of tissue damages caused by this toxic metal is oxidative stress, which in turn may cause numerous pregnancy complications such as preeclampsia. The present study was conducted to determine the relationship between maternal Blood Lead Level (BLL) and preeclampsia.MethodsThe present case-control study was conducted on 158 pregnant women admitted to a hospital in Zanjan, Iran, from August 2015 to March 2016. To measure their BLL, 1.5 cc of blood was drawn from each participant. The demographic and obstetric details of the patients were recorded in a form. The potentiometric method was used to test the samples. The data obtained were analyzed by SPSS version 22, using Mann-Whitney U test, the Chi square, independent-samples t-test, Pearson product-moment correlation, and simple linear regression analysis.ResultsThe mean BLL was 6.24±1.74 μg/dl in the control group and 8.04±3.4 μg/dl in the preeclampsia group. The two groups were matching in terms of the mother’s age and education and the household income. A significant relationship was observed between BLL and preeclampsia (p=0.028), as per every unit of increase (1 μg/dl) in BLL, systolic blood pressure increased by 0.014 mm Hg and diastolic blood pressure by 0.013 mm Hg (p=0.004).ConclusionThe results obtained suggest a relationship between BLL and preeclampsia. Global health measures should be taken to remove the exposure to lead so as to reduce its absorption by pregnant women.

Purpose: to assess the early hemodynamic changes after elective mitral valve replacement (MVR) in patients with severe and mild pulmonary arterial hypertension (PAH). Methods: a total of 45 consecutive patients, who were candidate for elective MVR, were enrolled in this prospective observational study. Patients were divided into two groups based on the absence (group A, 20 patients) or presence (group B, 25 patients) of severe pulmonary artery hypertension (PAH) defined as systolic pulmonary artery pressure ≥50 mmHg measuring by catheterization. MVR was performed using standard cardiopulmonary bypass (CBD) technique. The hemodynamic and arterial blood gas assessments were carried out at baseline before the induction of general anesthesia, in the operating room immediately after MVR, and then continued after stabilization of hemodynamic status with 2 hr interval up to 24 hours. Results: The mean CPB and aortic cross-clamp times were similar in two groups (95.3 ± 49.5 and 61.8 ± 36.3 minutes in group A and 103.1 ± 34.7and 61.9 ± 20.0 minutes in group B). In group A, the mean PAP showed an increase immediately after the operation (from 40.4 ± 7.3 to 43.10 ± 6.2 mmHg) and then decreased significantly to 32.5 ± 3.9 mmHg (P <0.05). In group B, the mean PAP showed no significant reduction immediately after MVR, but it decreased significantly below the range of severe PAP over the first 24 hours. Conclusion: MVR is safe and effective even in patients with severe PAH. The anesthetic technique and postoperative cares can be useful in improving the outcome in such patients.

Introduction The World Health Organization (WHO) defined domestic violence as "the range of physically, psychologically and sexually coercive acts used against adult and adolescent women by current or former male intimate partners" (1). Domestic violence is an important health problem in the countries, which devastates the configuration of communities and threatens the individual's life, health and happiness (2,3) Therefore, evaluation of the association between the different types of domestic violence and health consequences is required (4). In general, almost 40% to 50% of women reported some levels of domestic violence in their lives (5). Domestic violence threatens the psychological and physical health and sometimes leads to suicide (6). According to a statement by the WHO, preventing domestic violence against women has been presented as one of the most important health priorities (1). According to a national plan conducted in 28 provinces in Iran, 66% of the studied households reported experiencing violence at least once after marriage and the violence was severe and serious in 30% and 10% of the cases, respectively. The study also showed that violence caused a temporary or permanent damage to women (7). Among the main causes of domestic violence are low occupation level, low-income level of families and low education level (8) as well as addiction and criminal conviction of the spouse (9). Other causes of violence may include inadequate family support, substandard dowry given to the bride, smoking, women's lack of an independent source of income, marital dissatisfaction and the absence of consanguineous marriage (10). Furthermore, duration of marriage and being away from family (11), unwanted pregnancy (12), pregnancy more than 6 times, having 4 or more female children and being forced to give birth to a son were reported to be related to violence (11). Among other factors contributing to violence against women are sexual dysfunction, history of psychiatric disorders and experience of violence in childhood (5,11). Domestic violence causes a turbulent relationship between husband and wife which may harm the family relationship and impair psychological health and marital satisfaction (13). Based on the family systems theory, family members can both influence each other and be affected by other members. Therefore, any problem related to a member causes a challenge and a change in the family system (14). Violence and abuse in families occur frequently with significant impact on children of all ages (15). Studies have