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Showing 136 results for Ida

Akbar Pirzadeh, Gholamhosein Ettehad ,
Volume 2, Issue 3 (9-2002)
Abstract

 Background & Objective: Chronic otitis media infection exists among 1.5-2 percent of people and its purulent discharges can create some difficulties for the patients. Chronic otitis media is mainly due to pseudomonas aeruginosa and staphylococcus aurous. Severe and irreversible damages should be expected unless follow up treatments are exactly performed in such patients. This study was conducted to determine the most prevalent microorganisms involved in otitis infection and their sensitivity to antibiotics.

 Methods: This is a descriptive study in which 60 patients who referred to nose and throat clinics of Ardabil University of Medical Sciences (2000-2001) were selected. Using applicator, some samples were taken from suppurative discharges of middle ear. These samples were then cultured in lactose broth and Nutrient broth. In order to isolate pathogenic microorganism, samples were also cultured in blood agar. Sensitivity of isolated pathogenic microorganism was determined against some antibiotics. The data obtained were analyzed using SPSS software.

 Results: 56 out of 60 patients were culture positive. Microorganisms isolated from suppurative otitis media were Staphylococcus areus (31.6%), pseudomonas aeuroginosa (26.6%), proteus (20%), candida albicans (6.4%), Staphylococcus epidermidis (4.6%), aeuromonas (1.6%) and others (6.4%) respectively. Sensitivity of microorganisms to antibiotics was found to be Ciprofloxacin (94.6%), Co-trimoxazole (66.3%), Cloxacilin (64.3%), Chloramphenicol (64.3%),Cephalexin (64.3%), Erythromycin (60.7%), Amikacin (44.6%), Streptomycin (39.3%), Penicillin (5.4%) respectively.

 Conclusions: Since staphylococcus areus wasthe most prevalent micro-organism in otitis media infection, and isolated microorganisms were more sensitive to Ciprofloxacin, antibiogram test is necessary prior to the treatment of otitis media.


Mahnaz Norouzi , Heidarali Abedi , Maryam Farmahini-Farahani ,
Volume 2, Issue 3 (9-2002)
Abstract

  Background & Objective : Desire for using a contraceptive method depends on individual general attitude and perception about it as well as individual understanding, needs and other people ’ s expectation about using that method . This research is conducted to determine reasons for mothers ’ desire in choosing a specific type of postpartum contraceptive method .

  Methods : This research is a cross- sectional study. The subjects were 384 lactating mothers who referred to Isfahan Health Centers for family planning services for the first time after delivery. The data were collected using questionnaires filled out through interview. Descriptive and inferential statistic methods were used to analyze the data .

  Results : The results indicated that the most commonly used contraceptive method in lactating mothers was coitus interruptus (27.4%). The most common reasons of mothers for selecting this method was its safety (45.3%) and effectiveness (25.1%) .

  Conclusions : Because of the high failure rate of coitus interruptus, health personnel should present proper and enough training to lactating mothers and their husbands about different contraceptive methods. They should also present the application of different contraceptive methods in breast feeding and increase couples ’ ability in making proper decisions as well as choosing safe and suitable contraceptive methods .


Simin Atash Khoii,
Volume 3, Issue 2 (6-2003)
Abstract

  Background and Objective : Today, laparoscopic surgeries, because of reducing postoperative complications, are increasingly developing. Intraperitoneal insufflations of CO2and systemic absorption of it during laparoscopy results in hypercarbia. Using N2O during maintenance of anesthesia in these patients can enhance hypercarbia. This is because N2O increases the volume of pneumoperitoneum. This study was performed to determine the effect of N2O in enhancing hypercarbia during laparoscopy.

  Methods : Sixty Patients, with physical status I or II, undergoing outpatient diagnostic gynecologic laparoscopy according to ASA (American Society of Anesthesiology) scaling took part in this clinical and single blind trial, and were randomly divided in to two groups, each with 30 patients. In all patients, general anesthesia with end tracheal intubation was administered. The technique of anesthesia and ventilation were the same in all patients. Only, during the maintenance of anesthesia, N2O was not administered to group I (control) of patients, but in group II (case), patients received N2O, in 50% concentration in oxygen. The variables under study were evaluated and recorded at certain times and finally the data were analyzed using chi-square test, student t-test and EPI-5software.

  Results : There was no significant difference between two groups in terms of demographic data, homodynamic variables (heart rate, mean arterial pressure, and electrocardiogram changes), oxygen saturation, and the use of any additional analgesic drug (instead of N2O in group I). Comparing the End tidal CO2 (Etco2) in two groups indicated that Etco2 increases in those patients who used N2O during maintenance of anesthesia (p=0.02).

  Conclusions : With regard to significant difference between two groups in the enhancement of intraoperative hypercarbia (although it was not associated with homodynamic changes in this study), it is better not to use N2O in general anesthesia for laparoscopic procedures.


Farnaz Moslemi Tabrizi, Soosan Rassooli , Simin Atash Khoii , Rasool Azarfarin ,
Volume 4, Issue 2 (6-2004)
Abstract

  Background & Objectives: Nitroglycerin is found to have vasodilatory effect. It has also a relaxing effect on the smooth muscles of other organs including uterus. This study investigates the effect of intravenous nitroglycerin in emergency cesarean sections in which rapid and transient uterine relaxation for rapid and nontraumatic extraction of the fetus is necessary.

  Methods: Sixty pregnant women who were candidated for emergency cesarean and needed rapid uterine relaxation for different reasons were selected. These subjects underwent spinal anesthesia and at the time of uterine incision, 100 micrograms of nitroglycerin was injected to them intravenously. The time lapse between nitroglycerin administration and fetal extraction, the degree of uterine relaxation, the amount of intraoperative hemorrhage, uterine tone after fetal delivery and APGAR scores of the infants were all controlled and recorded. Also with regard to the vasodilatory effect of nitroglycerin and probably its resultant homodynamic problems, blood pressure, heart rate and arterial O2 saturation were recorded before and after nitroglycerin injection and throughout the surgery.

  Results: The results showed that in 53 (88.3%) of the patients the uterus was acceptably relaxed and the fetus was delivered very easily. Only in 7 patients (11.7%) uterine relaxation was not acceptable. The mean decrease in systolic and diastolic blood pressures after nitroglycerin administration compared with before injection BP was 12.97 mmHg (12.210 %) and 7.86 mmHg (12.208 %), respectively. There was not seen any prolonged effect of the drug such as uterus relaxation tone or abnormal bleeding. Also, none of the delivered infants had low APGAR scores. Besides, in patients with acceptable uterine relaxation the first and fifth minute APGAR score of infants were higher (p = 0.008, p = 0.000).

  Conclusion: This study shows that nitroglycerin can relax uterine smooth muscles very rapidly and transiently and in emergencies it can be an appropriate alternative to the other tocolytic agents with prolonged effect or onset time.


Ghodrat Akhavan Akbary , Abdolrasool Heidari , Shokouh Sadr Azodi ,
Volume 4, Issue 3 (9-2004)
Abstract

  Background & Objectives : Laryngoscopy and tracheal intubation may lead to tachycardia, hypertension and dysrhythmia or myocardial ischemia. In this double blind study, the effects of midazolam and lidocaine on hemodynamic response to endotracheal intubation have been examined.

  Methods : 52 ASA class one patients, aged 20-50, who were candidate for elective inguinal hernia surgery with general anesthesia, were randomly assigned to two groups. All patients received normal saline or Ringer's lactate solution (5ml/kg) about 5-10 minutes before induction of anesthesia and were preoxygenated for 3 minutes. Group 1 received midazolam (0.05 mg/kg) and group 2 received lidocaine (1.5 mg/kg) during 3 minutes prior to intubation. Anesthesia was induced with fentanyl (100 µ g) and thiopental (5 mg/kg) and trachea was intubated by the aid of succinyl choline (1.5 mg/kg). Anesthesia was maintained with halothane (0.5-0.75%) and equal proportions of nitrous oxide and oxygen. Systolic and diastolic blood pressure, mean arterial pressure (MAP) and heart rate were recorded before premedication and intubation, as well as immediately two and five minutes after intubation. The data were analyzed by SPSS software using paired t-test.

  Results : After intubationSystolic and diastolic blood pressure, MAP and heart rate increased in both groups compared to the baseline values. The difference in increasing diastolic blood pressure and MAP between the two groups was significant (p<0.05), but the difference in increasing systolic blood pressure and heart rate between two groups was not statistically significant. The increase in diastolic blood pressure and MAP in group 1 was significantly more than group 2 (p<0.05).

  Conclusion : Clinically, midazolam was as much effective as lidocaine in controlling response to intubations. Consequently it can be used as an alternative lidocaine in intubations. It has also other priorities such as amnesia, anti-anxiety and anti-agitation.


Mohammadhosein Dehghan , Bahareh Rajaee Far , Farnaz Ehdaivand , Firooz Amani ,
Volume 4, Issue 3 (9-2004)
Abstract

  Background & Objectives: Preeclampsia is still one of the leading causes of maternal and fetal morbidity and mortality. Despite active researches over the past many years, the etiology of this disorder in human pregnancy is an enigma. Oxidative stress has been implicated in the pathophysiology of preeclampsia. Essential nutrients such as vitamin C can scavenge free radicals inducing cellular damage. The present study was designed to investigate the plasma levels of vitamin C in patients with preeclampsia (case) and normotensive pregnant women (control).

  Methods: In this case-control study vitamin C as an antioxidant was estimated and compared spectrophotometrically in 40 preeclamptic and 80 normotensive pregnant women referring to Alavi Hospital of Ardabil province, Iran. The collected data were analyzed using descriptive and inferential statistics.

  Results: The plasma levels of vitamin C were significantly lower in patients with preeclampsia (0.147 ± 0.030 mg/dl) compared to controls who were normotensive pregnants (0.347 ± 0.119 mg/dl).

  Conclusion: Attempts at prevent preeclamsia are justified but since no reliable screening test has been offered as yet for women at risk, assessment of plasma level of vitamin C in patients prone to preeclampsia is strongly suggested.


Reza Ghotaslou , Zyiaaddin Ghorashi , Ebadollah Heidari , Solmaz Nikvash ,
Volume 4, Issue 4 (12-2004)
Abstract

  Background & Objectives: The conjunctiva is a mucus membrane that covers the internal surface of the eyelids and the external surface of the globe. Conjunctivitis comprises a variable group of infectious and non-infectious diseases. Bacterial conjunctivitis is a common type of ocular infections. The aim of this study was to determine the bacterial agents in conjunctivitis.

  Methods: This descriptive study was done on 148 patients with conjunctivitis who were hospitalized in pediatric hospital of Tabriz from March 2001 to February 2002 and had suppurative discharge. Suppurative discharge of the conjunctiva was sampled and cultured on suitable media. Antibiogram of the isolated strains was done using the disk diffusion method. The data were analyzed by SPSS software using descriptive statistics.

  Results : The isolated organisms were in the following frequency: Pseudomonas aeroginosa (40), Staphylococcus aureus(26), Klebsiella pneumonia(20), coagulase negative Staphylococci spp(18), Enterobacter spp(12), E.coli(10), Seratia marcescens(6), Acintobacter spp(4), Beta-hemolytic streptococcus group A(4). These bacteria had varied degrees of resistance to ciprofloxacin (37%), Chloramphenicle (52%), Gentamycin (70%) and Co-trimoxazol (71%).

  Conclusion: In different studies the prevalence of conjuctivitis infection is reported to be 20-40% but we found 94.5%. Regarding the importance of bacterial conjuctivitis infection in hospital and the possibility of the transmission of resistant infection to the society, some measures shoud be taken to decrease these infections.


Hormoz Ayromlou, Naser Safaii, Nasrolah Maghamipour ,
Volume 5, Issue 1 (4-2005)
Abstract

Ulnar nerve involvement is the second most common local mononeuropathy. The ulnar nerve consists of motor and sensory fibers that arise in C8-T1 roots and extends to the lower trunk and medial cord of brachial plexus. Manifestations of this nerve involvement range from elbow pain and intermittent hand paresthesia to marked sensory loss, wasting and weakness  of hand muscles and a claw hand. Ulnar nerve lesion in the elbow region commonly follows surgery in which general anesthesia is used (particularly in patients with coronary artery bypass graft surgery). The patient presented in this article was a 56-year-old male who was involved in left ulnar nerve lesion after undergoing coronary artery bypass graft. In electrodiagnostic study we noticed diffused demyelination lesion of the ulnar nerve with dominancy in elbow region along with secondary axonal degeneration. Therefore, suitable positioning of elbow is recommended to avoid the  nervous complications of these operations.


Mehri Jafari Shobeiri , Simin Atash Khoii ,
Volume 5, Issue 2 (6-2005)
Abstract

  Background & Objectives: It is estimated that as many as 75% of women experience at least one episode of vulvovaginal candidiasis during the lifetime and about 5% will have recurrent infections. There are clear association between vaginal candidiasis and uncontrolled diabetes mellitus. The purpose of this study was to determine whether non-diabetic women with recurrent vaginal candidiasis have an impaired glucose metabolism.

  Methods: This case-control study was carried out with 32 patients suffering from recurrent vulvovaginal candidiasis as case group and 30 control patients who had negative history of vaginal candidiasis during the previous year and had referred to the clinics for reasons other than vaginal candidiasis. The case group had referrd to the gynecology clinics three times during the previous year and were recognized to have vaginal candidiasis. They were being treated by antifungal drugs and had at least one positive candida culture. Both groups underwent standardized oral glucose tolerance test with 75-gram dose of glucose. The data were analysed using Chi-square and t-test.

  Results: Women with recurrent vaginal candidiasis had a mean body mass index greater than the control subjects (23.4 versus 21.5, p=0.001). They had no more incidences of overt or preclinical diabetes mellitus than the control subjects, but a greater proportion of them had at least one glucose concentration above the 95th percentile (p=0.015). Glucose concentrations were significantly higher in recurrent vaginal candidiasis cases than in control subjecs at 30, 60 and 75 minutes after the intake of 75-gram dose of glucose (p<0.05). This amount of glucose led to a 15.8% increase in serum glucose level in case group compared to the control group.

  Conclusion: Glucose tolerance test was mildy impaired in women with recurrent vaginal candidiasis. The plasma glucose concentration increased in 2 hours after 75 g glucose intake. Although the obtained results were not in the range of occult diabetes, it can designate the important of glucose tolerance test in women with recurrent vaginal candidiasis.


Ahmad Rahmati, Jan Brazier,
Volume 5, Issue 2 (6-2005)
Abstract

  Background & Objectives: Clostridium difficile as an etiologic agent of pseudomembraneous colitis and major cause of nosocomial antibiotic-associated diarrhoea is typed by phenotypic and molecular methods. The aim of this study was to investigate the distribution of ribotypes of the organism in the given region and time.

  Methods: In this study 18 strains isolated from patients from different hospital wards of Poland in 2002 and 2003, were examined and identified by susceptibility to vancomycin and metronidazole. The samples were re-identified using UV and latex agglutination to ensure the existence of A and B toxins. DNA was extracted and after amplification by PCR and electrophoresis, the strains were ribotyped.

  Results : The findings showed that all the strains were susceptible to vancomycin and metronidazole and all the colonies showed greenish-yellow fluorescence under UV. Moreover, all the strains were positive in terms of latex agglutination. Seven strains were toxin A positive and all were toxin B positive except one strain. In molecular ribotyping it was found out that these strains belonged to seven ribotypes, namely 12, 14, 17, 18, 29, 70 and 90 most of which were ribotype 17 (61%).

  Conclusion: Our observations imply that in each area a particular ribotype of c.difficile is of higher prevalence and ribotyping of this clostridium is necessary for epidemiologic studies. Identification and PCR-ribotyping of common strains of this organism in Iran are recommended for epidemiologic follow-ups.


Ahmad Hashemzadeh, Farhad Heidarian,
Volume 5, Issue 2 (6-2005)
Abstract

  Background & Objectives: Respiratory distress is one of the most important causes of children admission in hospitals. In most cases, it is due to pneumonia, asthma or acute bronchiolitis. Since theses diseases have a lot of symptoms in common, we decided to study these disorders in more details to facilitate the appropriate diagnosis and treatment based on clinical, laboratory and radiologic findings.

  Methods: 238 children who suffered from respiratory distress and were admitted to pediatric ward in Ghaem hospital were studied. This descriptive study was performed during 3 years including 2 retrospective and one prospective year. The relationship between variables was analyzed using chi-square test.

  Results: The patients were six months to five years old. Pneumonia (40.3%) asthma (30.3%) and bronchiolotis (16.8%) were the most common causes of respiratory distress. Totally, 61.1% of the patients were male. The mean age of the patients was 10.3 months in bronchiolitis and 36.6 months for asthma. The most common symptom among these three diseases was tachypnea. Most of the patients were admitted in winter and fall respectively. The main radiologic pattern in pneumonia was pulmonary infiltration and for asthma and acute bronchiolitis it was pulmonary hyperinflation.

  Conclusion: Proper attention to signs and symptoms as well as laboratory and radiologic fndings is necessary for accurate diagnosis. In this study the most common cause of respiratory distress in children under 5 was found to be pneumonia, asthma and bronchiolitis respectively.


Mohammad Hosein Dehghan, Ali Majidpour,
Volume 5, Issue 3 (9-2005)
Abstract

  Background & Objectives: Regarding the high prevalence of hyperlipidemia in the world especially in Iran, finding suitable and effective treatment seems justified. Metronidazole is the only drug that is used as an antiparasital and antiprotozoal agent. Researchers have found that oral dose of 750 mg/day has a suitable absorption, is widely distributed in the tissues and reaches to a blood level of 4-6 mg/ml. Despite its suitable efficiency, a few clinical trial have been conducted in this regard. This study was designed as such to examine the effect of metronidazole on lowering blood lipids.

  Methods: The present research was performed as a clinical trial without control, on 50 patients. All the patients filled out a special form (to show their satisfaction) as well as a questionnaire. Metronidazole was given with a daily dose of 750 mg for a week. 20 patients with no complaint continued their drug consumption for another seven days. Lipid parameters such as plasma total lipid, total cholesterol, and triglyceride were measured in both groups. The data were collected and analyzed with SPSS software using t-test.

  Results: Measuring the serum level of lipids indicated that the mean total plasma lipid and total cholesterol decreased significantly compared to their level before taking the drug (p<0.01). The findings also showed a similar decrease in plasma TG level (p<0.001). In the patients who continued the drug consumption in the second week, the serum level of lipids under study showed more decrease compared to their levels in the first week which was statistically significant (p<0.01). Liver tests indicated that the functioning of liver has not changed during drug consumption.

  Conclusion: Using 750 mg of metronidazole per day exerts a significant decrease in lipids fractions in a short time. Most cases of hyperlipidemia require a long-term treatment, hence metronidazole can be effectively used in the treatment of short-term hyperlipidemia.


Fariba Kahnamouei Aghdam , Farnaz Ehdayivand, Faride Mostafazadeh, Godrat Akhavan Akbary , Mohammad Sadeghi,
Volume 5, Issue 3 (9-2005)
Abstract

  Background & Objectives: Respiatory Distress Synderome (RDS) is one of the major risks of elective cesarian section whose negative health and econemical outcomes are obvious. Maternal prophylactic injection of corticosteroid drugs can reduce RDS of neonate to some extent. On the other hand corticosteroid drugs have some side effects such as delay in the healing of the incision. This study considered the effect of betamethasone on surgical incision.

  Methods: This study was conducted on 60 primipara women divied into two equal groups that were candidate for elective cesarean. We injected betamethasone (IM) to trial group twice 48 hours poior to operation, (every 24 hours) and complication of surgical incision was clinically evaluated within 7 days after operation in both groups. The data were collected and analyzed by SPSS software chi-square and Fisher tests.

  Results: Most patients (60%) were 20-30 years old and the average age in both groups was 21. The relative frequency of patients with complication of surgical incision in trial group (betamethasone recipients) was 30% and in control group was 23.33% (the difference between them was not statistically significant). The most common complications were erythema and hyperemia. Other complications observed in 15% of the patients included serousal discharge, local warmness and enduration. Rgarding these complications also there wasn’t a statistically significant difference between two groups.

  Conclusion: Betamethasone does not increase early onest complications of surgical incision and we can safely use betamethasone prophylactically for fetal maturion in elective cesareans.


Aligholi Sobhani , Mohammad Akbari,
Volume 5, Issue 4 (12-2005)
Abstract

  Background & Objectives: Anatomical position is the base for normal posture evaluation. Any deviation from this posture can create problems for an individual. Common faulty postures appear at the head, vertebral column, shoulder girdles, pelvis and other parts of the body. High flexibility of the primary school children’s skeleton increases the chance of faulty postures. Limited athletic activities of Iranian girls can lead to postural deficiencies among them, which can be followed by some irreversible complications. This study evaluated the rate of faulty postures and their risk factors among primary school girls and recommended some procedures for prevention and physical treatment of them.

  Methods: This descriptive study was conducted on all 261 students of Ghaem Motlagh primary school. The subjects ranged between 7 and 11 in age. The data were collected through physical examination carried out by an anatomist and a physiotherapist. These data were analysed using SPSS softwere (ver.6).

  Results: The finding showed that, 8.8% of the cases had abnormal rotation of the head. In lumbar region 1.5% involved hypolordosis and 6.9% hyperlordosis. Our results showed that there is a significant relationship between scapula winging and dominant hand (p=0.001).

  Conclusion: According to the results, it is suggested that sport activities under the guidance of a physical therapist, which involve all the body parts should be encouraged especially in girls schools.


Ahmad Hashemzadeh, Farhad Heidarian,
Volume 5, Issue 4 (12-2005)
Abstract

  Background & Objectives: Juvenile Immune Arthritis (JIA), which is a disorder with unkuown etiology, occurs in children under 16 and is one of the most common collagen vascular diseases in pediatrics and among the important causes of permanent deformity of joints and blindness in children. With regard to its importance, we studied the incidence, different types as well as clinical and laboratory features of this disorder.

  Methods: This descriptive and cross-sectional study was performed on 24 patients (age range: 6 months-12 years) admitted to pediatric wards of Ghaem and Imam Reza hospitals in Mashhad during 1998-2001. The data were collected from the patients’ records using a questionnaire and analyzed by SPSS software.

  Results: Polyarticular type was the most common form of the disease. Peak age of involvment was 11 years old. Boys were more frequently affected than girls. Knees, ankles and wrists were the most commonly involved joints. Most of the patients suffered from loss of appetite and irritability. Fever was detected in 100% of the patients with systemic type and 2/3 of the cases with polyarticular form. The most important laboratory findings were elevated ESR, positive CRP and anemia. There was an excellent response to aspirin or glucocorticoids.

  Conclusion: In comparison to similar studies the onset of disease in our patients was a little later. Fever was seen in all patients with sytemic disorder and skin rash was observed in most of the cases. So, it would be quite wise to suspect JIA in such cases. Aspirin or prednisolone are suitable drugs to treat most of these patients.


Reza Ali Panah Moghadam , Mohamad Rahbani Nobar ,
Volume 6, Issue 2 (6-2006)
Abstract

 Background & Objectives:Lipid peroxidation has recently attracted considerable attention. It has been linked to carcinogenesis, aging and variety of other diseases including atherosclerosis. Atherogenesis involves the complicated interaction between cells of the arterial wall and lipoproteins (mainly oxidized LDL). The aim of this study was to investigate the relationship between serum malodialdehyde (MDA), the important indicator of lipid peroxidation and alteration in serum lipids and lipoproteins concentrations in male patients with coronary artery disease (CAD).

  Methods: The subjects of this study were 51 male patients under 55 with angiographically comfirmed CAD admitted to Shahid Madani Hospital and 60 age and sex matched apparently healthy individuals as the control group. The serum level of MDA was measured by colorimetric method using thiobarbituric acid reaction and lipid and lipoproteins concentrations were determined by standard enzymatic methods.

  Results: Significant elevation in the level of MDA was noticed compared to the controls (P=0.03) . Serum concentrations of cholesterol, triglyceride, LDL-C and LDL - C /HDL - C ratio in cases were higher than those of the controls (P=0.03) . There was a positive and significant relationship between serum MDA and biochemical risk factors including Triglyceride, Cholesterol, LDL-C and LDL - C/HDL - C ratio (p=0.03). The correlation between serum MDA and serum HDL-C was negative and meaningful (P=0.03) . No relationship was observed between serum MDA with BMI and age in cases.

Conclusion: Simultaneous control and monitoring of both dyslipoproteinemia and lipid peroxidation may be of equal importance in prevention of occurrence and progression of CAD.
Faride Golfooroshan, Effat Khodaeiani , Shahla Babaei Nejad , Delara Laghosi,
Volume 6, Issue 2 (6-2006)
Abstract

  Background & Objectives: Diabetes mellitus (DM) is a clinically and genitically heterogeneous group of disorders characterized by abnormally high levels of glucose in blood. The skin is involved both in the effects of acute metabolic changes and in the chronic degenerative compilications of diabetes. Skin lesions are frequently observed in diabetic patients and it is generally stated that about 30% of these patients have cutaneous disorders. The aim of this study was to assess the prevalence of skin lesion in patients with diabetes mellitus referring to dermatology and diabetes clinic of Sina hospital in Tabriz .

  Methods: This descriptive-analytical study was conducted on diabetic patients with skin lesion who referr e d to diabetic and dermatology clinic of Sina hospital of Tabriz during 2003. Data collecting instrument was a questionnaire which included some variables such as age, sex, job, type of diabetes, its duration, control of blood glucose, receiving regular treatment, type of lesion. The questionnaire was filled out for each patient with skin lesion individally. Skin lesions due to burn were excluded from our study. The data were analyzed by SPSS using Chi-aquare and Fisher test.

  Results : From a total of 500 patients, 80 patients (16%) had skin lesions. 57.5% of these patients was male and 91.2% had type II DM. Mean age of the patients with skin lesion was 56.86±1.54 years and mean diabetes duration was 10.87±0.82 years. Patients over 50 years had the most skin lesion . The most common type of skin lesion in the diabetic patients were 30 cases of necrotic ulcer (6%) and 22 cases of diabetic dermopathy (4.4%) respectively. Other skin lesions such as infection, sclerodermoid, punched out lesions, neuropathic ulcer, diabetic bulla, dermatitis and lichen planus were not common . 97.5% of diabetic patients with skin lesion had poor control of blood glucose. Twelve percent of the patients had some kind of diabetic foot ulcer (Neuropathic Necrotic, punched out and cellulitis ulcer altogether) of which 21.6% underwent amputation.

  Conclusion: The results showed that rate of skin lesions in diabetic patients is decreased. compared to the past. This may be due to increase of knowledge and attitude of patients regarding diabetes and its complications.


,
Volume 6, Issue 2 (6-2006)
Abstract

  Background & Objectives: Diabetes mellitus may be associated with the imbalance between protective effect of antioxidants and increased free radical production with regard to discrepancies of the findings in previous researches the present study set out to determine the changes of plasma malondialdehyde and erythrocyte antioxidant superoxide dismutase activity in patients with type II diabetes mellitus.

  Methods: This case-control study was conducted in 2005 using random sampling. 38 patients with type II diabetes mellitus who referred to 5th Azar diabetes center and 19 age and sex matched healthy controls were selected for this study. Heparinated blood samples were taken from the cases. The separated plasma was tested for blood sugar, lipid peroxidation and blood cells (for glycolisated Hb and superoxide dismutase enzyme activity). The collected data were analyzed by SPSS (ver. 10) using t-test.

  Results: The level of plasma malondialdehyde from type II diabetes mellitus patients (6.27±0.80 nmol/ml) was significantly different from that in control group (3.56±0.98 nmol/ml)(p<0.05). Erythrocyte superoxide dismutase activity from type II diabetes mellitus patients (678.78±59.36 U/gr Hb) was significantly lower than control group (1056.47±52.98 U/gr Hb) (p<0.05).

  Conclusion: The significant difference between the increase in malondialdehyde and decrease in the activity of antioxidant enzymes in patients with type II diabetes mellitus may predispose to the development of serious complications leading to cellular damage. This suggest that diabetic patients may need more antioxidants than normal. Supplementation with medical or non-medical free radical scavengers such as vitamins E and C or foods untaining vitamin C (sitrus fruits) have a potential role in reinforcing antioxidant defence and can be important in diabetic patients.


Ghodrat Akhavan Akbari , Masoud Entezariasl , Firooz Amani ,
Volume 6, Issue 3 (9-2006)
Abstract

  Background and Objectives: Laryngoscopy and tracheal intubation could lead to hemodynamic responses in the from of hypertension and tachycardia as well as arrhythmia and myocardial ischemia. This alterations can be life-threatening particularly in elderly people. This clinical trial compared the effects of two rapid-onset narcotics, Alfentanil and Remifentanil, on the hemodynamic responses to the induction and tracheal intubation in elderly patients.

  Methods: This double-blind clinical trial was conducted on 40 subjects aged 65 and above. They were candidate of cataract surgery under general anesthesia. The patients were randomly allocated to two groups of 20. The first group, was gaiven Alfentanil 10 m g/kg and for second group Remifentanil 0.5 m g/kg was injected prior to the induction of anesthesia. Both groups were similiar in the method of anesthesia except in narcotics. The first group was infused with Alfentanil 1 m g/kg/min and Remifentanil 0.1 m g/kg/min was used for the second group. Hemodynamic variations including heart rate, systolic, diastolic and mean arterial blood pressure were measured and recorded eight times (before induction, aften injection, after intubation and five times during anesthesia). Data were analyzed with SPSS software using descriptive and analytical statistics such as T-test, chi squre and ANOVA.

  Results: Immediately after injection of narcotic drugs, all hemodynamic variants decreased. Howerver diastolic blood pressure in Remifentantil group significantly more than Alfentanil group (P<0.05). After laryngoscopy and tracheal intubation all hemodynamic variants increased and slowly decreased in less than 10 minutes. Systolic, diastolic and mean arterial blood pressure decreased significantly in remifentanil group than alfentanil group (P<0.05). Although heart rate decreased during few minutes after intubation, there was not significant difference between two groups regarding this decrease (P>0.05). Ephedrin was used to treat severe hypotention in those under Remifentanil (11 patients) more than those under Alfentanil (4 patients) (P<0.05).

  Conclusions: According to the resukts of this study Remifentanil could prevent hemodynamic variation induced by laryngoscopy and treacheal intubation more than Alfentanil. However in some cases Remifentanil leads to hypotension during anesthesia. There is no important difference between two drugs in increasing heat rate after laryngoscopy and intubation.


Reza Rastmanesh , Rahebe Shaker , Mehrdad Shoa , Yadollah Mehrabi , Lida Navayi,
Volume 6, Issue 3 (9-2006)
Abstract

  Background and Objectives: Early diagnosis of diabetes can prevent many unwanted and irreversible consequences which require a lot of expenses as well as advanced treatment methods and experts. The present study set out to compare prevalence of diabetes in first degree relatives (FDR) of patients with type II diabetes mellitus (T2DM), glucose intolerants and controls.

  Methods: In This case-control research, 277 healthy subjects (129 males and 148 females) with the age of 11-95 were selected from among FDR in three groups, namely those with type II diabetes, glucose intolerants and controls and were evaluated in terms of diabetic condition. World health organization criteria were applied to recognize case(s) of diabetes and glucose intolerants.

  Results: Odds ratio of being type 2 diabetic or IGT, in FDR of patients with T2DM and subjects with IGT, 5.261 compared to controls was (with 95% CI of 2.15-12.82). Prevalence of T2DM and IGT in both male and female FDR of patients with T2DM and with IGT, was significantly higher than that of controls (p< 0.005).

  Conclusion: Significantly higher prevalence of T2DM and IGT in FDR of patients with T2DM and with IGT, compared to controls, offers a very quick and cost-effective method of diagnosing covered cases of diabetes in country's health care systems.



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مجله دانشگاه علوم پزشکی اردبیل Journal of Ardabil University of Medical Sciences
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