---

  Abstract

  Introduction: Supervision is one of the effective tools for assisting managers and health workers toward increasing efficacy and effectiveness of service delivery and the needed health care of the target groups. The aim of this study is to determine the effect of supportive supervision in improving the quality of performance of Ilam health system network.

  Methods and materials: This is a semi-experimental study. The statistical groups consist of members of supervision teams who work in the eight district health networks at the provincial level. The intervention of this research is an educational program for the supervision teams conducted via a workshop method. By determining the relevant indicators, different domains elated to developing and implementing health programs at the health centers’ level that providing health care and comparing the results before and after the intervention.

  Research findings: The difference between the mean performance of the supervision teams due to the effect of supervision training in areas such as determining the situation analysis, priority setting of the problems, introducing appropriate solutions, developing operational plans and evaluating the health programs’ effectiveness before and after the intervention which was statistically significant ( P ˂ 0 .01).

  Conclusion: Regarding the effect of implementing supportive supervision model in raising knowledge and performance of the health network supervision teams and ultimately improving the health indicators. Through implementation, this model might have an important role in increasing the efficacy of the health system and results in the improvement and development of the level of community health.

  Key words: supportive supervision, supervision team, monitoring, evaluation

 

 

---

Introduction: Worldwide, migraine is a chronic disease that it annually affects 6% of men and 18% of women. It is a common disorder in childhood and adolescence periods. Studies have indicated that riboflavin intake can play important role in reduction of migraine symptoms. Therefore, the purpose of present study was to review the researches which conducted in field of relationship between riboflavin and symptoms of migraine.
 Materials & methods: This systematic review was conducted by searching on PubMed, Scopus, Science Direct and Web of Science data bases and using keywords including: “migraine”, “headache”, “riboflavin” and “vitamin B2”. In this article, we were reviewed clinical trial, cross-sectional, retrospective and prospective studies which published during 1994 to 2014. Inclusion criteria were studies that diagnosed migraine with IHS criteria and they were performed on human, and exclusion criteria included non-English language articles and studies that investigated headaches as the main aim.
 Findings: of 76 articles we found, the final analysis was based on 7 articles. Investigated studies on adults showed that riboflavin supplementation in high dose (400 mg) not only improve the migraine symptoms, but also have a prophylactic or preventive role in development of migraine attacks. Studies that were performed among children showed that taking 400 mg riboflavin improve migraine symptoms, but taking lower doses such as 200 or 50 mg, showed no significant effect on migraine symptoms.
 Discussion & Conclusion: Riboflavin in high-doses (400 mg) probably reduces migraine symptoms both among adults and children. But due to few studies in this field, further studies are recommended.

---

Introduction: Modeling is one of the most basic methods to explain the statistical variables that by using it we can realize the response variable distribution. Mixture distribution can improve the goodness of fit largely, so, the aim of this study was to introduce the mixture of logarithmic series distribution and modeling of effects of nutrition on complications in diabetic patients by it.
 Material & methods: This study examined appropriate model fitted related to diabetic patient's data after introducing the mixture of logarithmic series distribution. 32 variables have been considered which related to type and consumption instruction of food as independent variables and complication as dependent variable.
Findings: The results showed that according to chi-square value of Mixture logarithmic series distribution, fitted model with a mixing ratio of 1/32 to all independent variables are reasonable model.
 Discussion & Conclusion: given that data of diabetic patients' complications have no zero density and also comparing χ^2 statistic from mixture of logarithmic series distribution combined and mixed Poisson distribution, we find that mixed logarithmic series distribution model gives a better fit to data.

---

Introduction: Associated with obesity, weight loss has increased significantly during the past two decades, which is still one of the most common disorders. The aim of this study was to investigate the effect of 4 weeks of resistance training combined with alfalfa extract on cathepsin S and cystatin C in weight loosed Girls.

Materials & methods: This study was conducted on 28 adolescent girls with weight loss. They were randomly divided into four groups (each group,n = 7): exercise, exercise-supplement, control, control –supplement.Resistance exercise training protocol consisted of 4 weeks and 3 days a week with 60% of one repetition maximum (1RM) at the beginning and 80% of 1RM at the end. Supplement groups consumed alfalfa extract1 cc (per kg body weight) and blood samples were taken before and after 4 weeks of the study.

Findings: After 4 weeks concentrations of cathepsin S and cyctatinC in exercise group exercise–supplement and Control-Supplement was significantly reduced (p<0.05). But in control group there was no significant decrease (p<0.2).

Discussion & Conclusions: This study showed that 4 weeks of resistance training combined with alfalfa extract increased weight, decreased levels of cathepsin S and cyctatin C, which resulted in body composition improvement.

---

Introduction: The enhancement of proficiency in any organization especially in health and treatment centers being more exposed to job stress needs to care more about human labor force. Therefore, according to the importance of the efforts of health care providers (Behvarzan) in improving the health system of the country, this article is provided to study the effects of training the skills of coping with stress on the health care providers’ performance.

Materials & methods: Regarding the purpose and functional conclusion, the current study is from intervening semi- experimental surveys haring two groups of testing and controlling. The study cases for this research include all the health care providers in health centers in Ilam township during 2014 being 60 people and for some limitations the number was carried out through census and randomly divided into two 30-member groups of testing and controlling. Then, the testing group was given coping with stress instructions. To get desired results in this study, Pierson testing and variance analyzing methods were used.

Findings: The results of this research showed that there is a contrary and meaningful relation between job stress and task performance. (p ≤ 0/05). It is also shown that training ways to cope with stress did not affect ability elements, authority and the role in health workers’ performance. (p ≤ 0/05) but it affected elements such as support, motivation, reaction and environment in health care providers. (p ≤ 0/01)

Discussion & Conclusions: According to the fact considering the effects of training the skills of coping with stress over the job performance among health care providers, it is suggested that training workshops targeting coping with stress should frequently be held for all the staff of health centers as well as health care providers.

---

Introduction: Recurrent pregnancy loss (RPL) is defined as the occurrence of two or more abortion before 20^th week of gestation. The etiology of RPL is unknown in 50% of cases, which defines as idiopathic RPL (IRPL). Immune-related embryo injuries play an important role in the occurrence of RPL. Interferon regulatory factor-5 (IRF-5) is a member of IRF family of transcription factor, acts as upstream regulatory element of inflammatory cytokines (IL-6, and TNF-α). The aim of the present study was to investigate the relationship between IRF-5 gene rs10954213 polymorphism in the occurrence of IRPL.
 
Materials & Methods: In this case- control study, blood samples were collected from 176 IRPL women with a history of at least 2 miscarriages with mean age of 34.2±10.9 years as the patient group, and 173 healthy postmenopausal women with at least two live births, and without a history of previous miscarriage (mean age±SD; 56.5±7.7 years) as the control group. Genotyping was performed using T-ARMS PCR. The data were analyzed using SPSS v.16 software.
 
Findings: The frequency of G allele was lower in cases compared to control subjects. This difference was statistically significant and supported the protective effect of this allele against miscarriage (OR: 0.7, 95%CI: 0.5-0.9, p=0.04). The frequency of G carriage genotypes (GG+GA vs. AA) in women with IRPL was lower compared to the women of the control group and showed the protective role of this allele (OR:0.45, 95%CI:0.22-0.91, p-0.02).
 
Discussion & Conclusions: Regarding the results of the present study, the rs10954213G allele of the IRF-5 gene demonstrated a protective marker against idiopathic recurrent pregnancy losses in Iranian women.
 

---

Introduction: Multiple sclerosis (MS) is a disease of the central nervous system in which myelin is destroyed. Oxidative stress and subsequent apoptosis are recognized as factors involved in the pathogenesis of MS.  On the other hand, 17-β-estradiol is well known  for its anti-oxidant properties. Therefore, this study aimed to investigate the effect of 17-beta-estradiol on oxidative stress parameters in the experimental model of MS.
 
Materials & Methods: This study was conducted on 49 Wistar male rats cannulating into the CA1 area of hippocampus. The rats were randomly divided into following groups (n=7): control group, sham group, MS group, estradiol groups, MS+estradiol groups. MS model was induced by intrahippocampal injection of ethidium bromide and estradiol was injected as a pretreatment for 5 days. At the end of experiments, the levels of oxidative stress parameters, such as MDA, Glutathione, and antioxidant enzymes (Glutathione peroxidase, Superoxide dismutase and Catalase)were measured in this study.
 
Findings: The microinjection of ethidium bromide increased the oxidative capacity and reduced the antioxidant enzyme (SOD GPx and CAT) activity (P<0.05). The pre-treatment of 17-beta-estradiol prevented an increase in oxidative capacity and decreased the activity of antioxidant enzymes in the experimental groups (P<0.05).
 
Discussion & Conclu sions: The 17-beta-estradiol, as a potent antioxidant, is likely to prevent the increase of oxidative stress indices in the experimental model of MS by removing reactive oxygen species and clearing the tissues from free radicals.

---

‌Introduction: Spinal cord injury is one of the important unresolved problems in the medical society leading to adverse consequences, such as motionlessness and neuropathic pain. Neuropathic pain is seen in both forms of hyperalgesia and allodynia. In this study, the effects of low-level laser radiation on hyperalgesia pain have been investigated.
 
Material & Methods: In this experimental study, animals (N=16) were divided into two groups(i.e., spinal cord injury and laser treatment). Aneurysm clip was used to induce spinal cord injury. Half an hour after the induction of spinal cord injury, animals were exposed to laser for 45 seconds every day up to four weeks. At the end of each week, the animals underwent a heat-hyperalgesia test. The results were analyzed in Prism software,version 6 .The value of  P <0.05 was considered significant.
 
Findings: Surgery of the induced spinal cord injury reduced threshold of hyperalgesia pain, compared to the control group (P<0.001). Low-level laser radiation for four weeks increased the pain threshold so that the pain proved equal to the control group and there was a significant difference between treated and spinal cord injured animals (P<0.001).
 
Discussion & Conclusions: Using a low-level laser as an anti-inflammatory agent in the first line treatment can be useful in controlling injury side effects shortly after a spinal cord injury; moreover,it can reduce the pain and inflammation caused by spinal cord injury.

---

Introduction: Genetic factors play an important role in the development of type 2 diabetes. The aim of this study was to investigate the prevalence of polymorphism CASQ1 (rs2275703) in 100 patients with type 2 diabetes mellitus (T2DM) in Kurdistan, Iran.
 
Materials & Methods: This study was conducted based on a case-control design. After obtaining the informed consent, the blood samples were obtained from patients with T2DM who were over 35 years of age. In total, 100 blood samples from the patient group and 100 blood samples from the control group (with matched age and gender) were assessed for the status of CASQ1 (rs2275703) using Tetra-Arms polymerase chain reaction method. The data were then analyzed statistically. Ethics code: IR.MUK.REC.1396/319
 
Findings: Out of 100 healthy individuals (60 males and 40 females), 34 and 47 ones had genotype AA4, respectively. Moreover, 4 and 13 cases had genotype AC, and 0 and 2 individuals had genotype CC. Additionally, out of all healthy individuals and diabetic patients, 81 and 71 cases had genotype AA, respectively; moreover, 17 and 25 cases had genotype AC. In addition, out of 100 healthy individuals and 100 patients, 2 and 4 cases had genotype CC, respectively. There was no significant relationship between CASQ1 rs2275703 polymorphism and T2DM (P=0.241).
 
Discussion & Conclusions: According to the results, no significant relationship was observed between CASQ1 (rs2275703) polymorphism and T2DM in the population under study.

---

Introduction: Aging is associated with several health threats, including poor sleep quality which is one of the most common problems among elderly people. Sleep problems are prevalent in hospitalized elderly patients, out of which one can name having trouble falling asleep or waking up frequently during the night. Therefore, the aim of this study was to evaluate the sleep quality of elderly patients with coronary artery disease admitted to Imam Ali Hospital, Kermanshah, Iran, during 2018.
 
Materials & Methods: This cross-sectional study was conducted on 200 elderly people with coronary artery disease. The sampling was performed using a continuous method. After data collection, the data were analyzed in SPSS software (version 25). A p-value less than 0.05 was considered statistically significant. Ethics code: IR.IUMS.REC.1397.800
 
Findings: The mean±SD age of the elderly was 68.87±7.83 years. Regarding the sleep quality, the majority of the elderly (75.5%) had poor sleep quality. Moreover, sleep quality had no significant correlation with age, gender, marital status, educational level, and occupational status.
 
Discussions & Conclusions: Based on the results of this study, the sleep quality of the majority of the elderly was poor. Moreover, sleep quality was not significantly correlated with demographic characteristics. Therefore, health policy makers should consider necessary interventions in education regarding the importance of sleeping for the elderly and their families.
 
 

---

Introduction: Carob (Ceratonia siliqua L.) is a tree belonging to the Leguminosae family. It is used for forestry and ornamental purposes. The tree is of importance due to its medicinal properties and its ability to treat infertility.  The present study aimed to investigate the chemical composition and fatty acid profile of the fruit.
 
Materials & Methods: Maximum extraction yields of the fruit were determined by utilizing different solvents for extraction. Methanolic extracts of the fruit were analyzed by GC-MS. EDS analysis was utilized for elemental analysis of the dried fruit powder (pods). The fatty acid profile of the fruit was determined by GC-FID. Antioxidant properties of the extracts were evaluated utilizing the ABTS assay.
 
Findings: Highest extraction yields were obtained with water. Phytochemical tests confirmed the presence of saponins, alkaloids, flavonoids, tannins, glycosides, steroids, and terpenoids in ethanolic extracts of the fruit. In total, 38 organic compounds were identified in methanolic extracts of the fruit, most of which belonged to fatty acids. Totally, 8 minerals were identified of which copper and zinc were the main minerals. Analysis of lipid extracts revealed the presence of eight fatty acids. Antioxidant activity of the extracts showed that aqueous extracts had the highest IC₅₀ value.
 
Discussions & Conclusions: The role of Carob fruit in the treatment of infertility can be due to the presence of many antioxidant compounds and their role in reducing oxidative stress in sperm and also the presence of nutrients as cofactors involved in the path of oxidative stress and also the presence of abundant fatty acids.