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Showing 885 results for Type of Study: article
Firooz Amani , Manoogehr Barak , Naiere Aminisani, Mohammad Hosein Dehghan ,
Volume 5, Issue 4 (12-2005)
Abstract
Background & Objectives: Providing, maintainance and promotion of neonatal health as a special high-risk group has a special role in heath services. According to statistics, 4 million out of 130 million neonates, born every year, die in the first week of their life. 99% of this mortality takes place in developing countries. 38% of the deaths below the age of 5 belongs to neonatal deaths. To decrease this mortality, some factors such as mother condition (including health care both before and after pregnancy), perinatal factors and life-threatening factors in the first 28 days after birth. This study was performed in hospitals under Ardabil University of Medical Sciences to determine the related factors of neonatal mortality. Methods: This case-control study was conducted on 160 neonatals (80 cases of neonatal deaths and 80 live births as controls). The demographic data of two groups were separately analyzed to obtain descriptive results. Also the most common causes of neonatal mortality were obtained through studying cases. Moreover, the parents of live neonates were asked questions to evaluate the effect of social factors. Finally all of these related factors were compared. Results: From 160 neonates under study, 71 (44.4%) were female and others were male. Neonatal mortality in males was 1.3 times as much as that in females. 16(12.1%) mothers had history of still birth. 18(11.3%) mothers were illiterate and 27 (16.9%) had college education. 31(19.4%) neonates were under 1500gr, 42 (26.3%) 1500- 2500gr and others above 2500 gr. 37 (46.3%) mothers in case group and 24(30%) in control had no access to transportation facilities. The most common causes for neonatal mortality were prematurity with 44 (55.1%) cases and aspiration, septicemia, asphyxia each one with 4 (2.5%) cases. There were statistically significant relationship between neonatal mortality rate on the one hand and birth weight, access to transportation facilities and mothers, living place (rural or urban) (p=0.023). Conclusion: According to the results, factors such as birth weight, access to transportation facilities as well as the mothers’ living location (rural or urban) were determining factors in the neonatal mortality. Some measures seem necessary to by taken in order to decrease the effect of thses factors.
Bahman Bashardoost , Hosein Doostkami , Ziba Faalpoor , Khadige Eslamnegad, Ali Abedi ,
Volume 5, Issue 4 (12-2005)
Abstract
Background & Objectives: Cardiovascular events are among the most common causes of mortality in patients with end stage renal disease. Caediac biomarkers such as troponins are very sensitive in diagnosing heart problems. Troponin I can be used to diagnose acute cardiovascular problems in hemodialysis patients. Methods: In this descriptive-analytical and cross-sectional study the level of troponin I was measured in 39 hemodialysis patients using ELISA method and BUN, Cr and Hb level before hemodialysis. LVH and LVMI were determined by echocardiography. The data were analyzed using SPSS. Results: The patients were 52.92 years old on average. 26 patients were male and 13 female. The average of tropnin I was 0.78 μ g/l. There was no meaningful relationship between troponin I and LV MI, age and sex. However, a significant relationship was found between the level of troponin I with EF and diastolic dysfunction (p=0.05). Conclusion: Troponin I can be regarded as an indicator of LV dysfunction.
Afshar Tamook, Farhad Salehzadeh, Naiere Aminisani , Goubin Moghaddam Yeganeh,
Volume 5, Issue 4 (12-2005)
Abstract
Background & Objectives: The incidence of neonatal hyperbilirubinemia disease is noticeable. Studying neonatal hyperbilirubinemia and its related factors is a step to reduce its incidence and remarkable treatment expenses. On the other hand, due to lack of on time recognition and suitable treatments, this disease can cause irreversible neuro-cerebral complications. This study was conducted to examine the etiology of neonatal hyperbilirubinemia and its associated signs, in order to provide on time and suitable treatment measures.
Methods: This cross-sectional study was performed in 2003 on neonates affected by neonatal hyperbilirubinemia in Ardabil Sabalan hospital. The data obtained from their conditions, clinical examination, and measurment of total and direct bilirubine was used to fill out a questionnaire. The data were analyzed by SPSS software (release 10).
Results: From among 132 neonates affected by neonatal hyperbilirubinemia, 50% were male and others were female. 85.6% of these subjects were fullterm births and the rest were premature. 56% of these neonates were born by C/S. 6.8% of hyperbilirubinemia cases, which were considered as “pathologic”, occurred during 24 hours after birth. 72% were related to the second to seventh days of birth, 17.2% to second week of birth, and the rest (4%) had prolonged Icter. 65% of these neonates were the first children of the family. The average time of hospitalization was 4.8 days. 34.8% of these neonates had pathologic signs beside hyperbilirubinemia and had a clinically serious condition. About 23% of these neonates were born by C/S and only 11.8% of them were vaginal births. 46 cases (34.8%) had accompaynig pathologic problems in addition to Icter, among whom 33 children (25%) had evident infection. The causes of hyperbilirubinemia were Crigler-Najjar syndrome in one case, ABO in 11 cases (8.33%) and RH discord in 4 cases (2.8%). Generally speaking the precise cause of 36.89% of Hyperbilirubinemia was determined.
Conclusion: Some factors such as children by C/S, neonatal infection, prematurity, ABO discords and RH discords play an important role in hyperbilirubinemia incidence and severity.
Shahram Habibzadeh, Zahra Tazacori , Firooz Amani , Uoones Sheshgellani, Khadige Khodapanahi ,
Volume 5, Issue 4 (12-2005)
Abstract
Background & Objectives: Since 1985 because of increasing incidence of tuberculosis (TB) in HIV background, the outbreaks of TB have been reported in different parts of the world. From 1985 to 1991 the incidence of TB increased by 18% in United States and Europe. In Multi Drug Resistant outbreaks of TB in United States 18 to 35% of heath care workers (HCW) who had exposure to TB patients had PPD Converted to positive test (Seroconversion). That is why the risk of TB incidence in health care workers has been put forward again. This study was designed to determine the rate of Buali hospital HCW exposure to mycobacterium tuberculosis. Methods: All 96 HCW of Buali hospital took part in this cross-sectional and analytical study. No PPD test was performed for HCW in this hospital in the beginning of their employment. For this reason 30 officers who had not previously worked in hospital wards and 60 medical students who had not started their clinical course were selected to obtain an estimation of PPD test before starting professional nursing. Results: Out of 96 subjects, 72 were female and 24 were male. Rate of positive PPD was 50% in general. Data analysis showed that PPD positivity was in direct relationship with number of working years in hospital. In 60 university students whose mean age was 21.6± 0/2.9 PPD positivity rate was 13.3%. I the third group consisting of 30 office workers (mean age=333±6.5) it was 23.3%. Conclusion: This study shows that HCW with 50% of PPD positivity are in exceeding probability of mycobacterium tuberculosis exposure, which is almost twice as much as the other office workers, possibility of exposure.
Khosro Hazrati Tappeh , Mohammad Rahbar , Sasan Hejazi, Mahiar Mostaghim ,
Volume 5, Issue 4 (12-2005)
Abstract
Background & Objectives: Cryptosporidium is a coccidial protozoa parasite belonging to subphylum of Apicomplexa. Although it is globally widespread and its species exist all over the world, this parasite was unknown until several years ago. Nowadays it is considered as an important infective agent in Immunocompromised hosts especially patients with AIDS. Due to high mortality rate of this infection in immunocompromised and cancerous patients and because of the popularity of Urmia as one of the animal husbandry regions in Iran and since this disease is likely to transfer from animals to human beings this study was conducted to determine the rate of contamination with this parasite. Methods: This case-control study was performed on 72 children (case) with cancer who referred to oncology clinic of Urmia Imam Hospital during 2001. Another 30 children with normal immune system were selected as controls. To determine the amount of contamination with parasite, two fecal specimens were collected from each patient. After being concentrated with Formalin–Ether, these specimens were examined using modified acid fast method. Results: Three cases ofcryptosporidiosis was seen in the patients (4.16%). Of these, there were 2 patients from the rural area and 1 from urban region. There was no significant relationship between the presence of cryptosporidiosis and living in rural or urban areas. Conclusion: Cryptosporidium was detected in three cases of the patients under study who were undertaking chemotherapy. However since the population under study was small, no statistically significant relationship was found between being immunocompromised and contamination with parasite.
Reza Khandaghi , Hormoz Ayromlou, Reza Nabeei, Mohammad Ali Arami, Paiam Khomand,
Volume 5, Issue 4 (12-2005)
Abstract
Background & Objectives: Acute optic neuritis in majority of cases, especially young females, is a common presentation of multiple sclerosis. Visual evoked potential (VEP) study is a non-invasive method for evaluation of nerve conduction of optic nerve. This study is an attempt of follow patients with acute optic neuritis and VEP variations over the time. Methods: VEP was studied in 30 patients with acute optic neuritis (25 females (83.3%) and 5 males (16.7%) with a mean age of 28.77±9). Clinical examinations and brain MRI study were performed on each. Examinations were repeated 1 and 6 months later. Statistical analyses were performed with SPSS software(rel.11). Results: Physical examination revealed another neurologic abnormality in 12 patients (40%). Brain MRI in 19 patients (63.3%) was abnormal. Latency of P100 was abnormal in all cases and only in 7 cases VEP was in normal range after 6 months. Definite MS was diagnosed in 15 cases (50%) and probable MS in 4 patients (13%). P100 amplitude in first study had no prognostic value for recovery. Conclusion: VEP has a sensitivity of about 80% for optic nerve injury and the comparison between two eyes is required for the diagnosis of this disorder. Careful clinical examination and brain MRI in the first admission as well as follow-up activities should be done for early detection of multiple sclerosis.
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.
Daruoosh Savadi Oskoyi , Ali Abedi, Reza Khandaghi,
Volume 5, Issue 4 (12-2005)
Abstract
Background & Objectives: Hypokalemic paralysis is a relatively uncommon syndrome which is potentially dangerous. If it is diagnosed and treated timely, the patients will be saved without any side effects. Various diseases can lead to this syndrome which is characterized with decreasing of serum potassium and acute systemic paralysis. In hypokalemic paralysis, the serum level of potassium reaches to less than 3.5 Mmol/lit. This may be caused by transferrence of K to intracellular department, (periodic hypokalemic paralysis and periodic thyrotoxic paralysis). The aim of this study was to determine sex and age prevalence of these patients as well as other features of the patients suffering from periodic hypokalemic paralysis. Methods: 55 patients participated in this prospective, descriptive and cross-sectional study which was conducted from 1999 to 2003. These patients were referred to the neurological department with hypokalemic diagnosis on the basis of laboratory and clinical examinations. The data were collected using a questionnaire. Also the serum level of K was measured. The data were analyzed by SPSS software. Results: from 50 patients, 46 (92%) were male and others were female. The patients were in 19-60 age range (Mean=33.16 SD=9.1). Mean serum level of K+ was 2.37 Mmol/lit (SD= 0.49) in the first hospitalization. The incidence of hypokalemia increased with aging , but majority of the patients (76%) were in age range 20-40. In 86% of the patients the time of hypokalemia crisis was at night and early morning. 11 patients had a high consumption of rich carbohydrate foods previously and 11 others had consumed corticosteroids. There was relapse of disease in 21 patients. 40 patients had paralysis in 4 extremities and 12 patients in 2 extremities. 4% of the patients were hypertensive and 4 patients were hyperthyroid. EKG was normal in 8 patients but in other cases there were abnormal changes. Conclusion: Despite the international references, the incidence ratio of male to female is high but the decreasing of K is more severe in female. Asetazolamide and oral KCL therapy not only decrease the period of hospitalization, but also are more effective in treatment of the disease.
Samad Gaffari, Ali Golmohammadi,
Volume 5, Issue 4 (12-2005)
Abstract
Background & Objectives: Acute myocardial infarction (AMI) is one of the most common causes of admissions in industrialized countries and each year a lot of deaths occur due to this disease. AMI is commonly associated with leukocytosis and an elevated neutrophil count. It is not clear whether neutrophilia is a cause or effect of acute myocardial injury and heart failure. Nevertheless, proving such a correlation will have a lot of clinical utilities. Methods: From among 146 patients hospitalized by AMI diagnosis in the CCU ward of Shahid Madani hospital, 68 patients (having our inclusion criteria) took part in this cross-sectional and analytical study. The criteria for AMI were clinical symptoms, ECG criteria and paraclinical findings. CBCH1 was performed for the patients. All the patients were evaluated for presence or absence of congestive heart failure (CHF) in first 4 days of hospitalization. The data were analyzed with SPSS software using t-test and Chi-square. Results: Mean neutrophil count was 11291 in patients with evidence of congestive heart failure (CHF) and 8440 in those without it (P =0.01). This difference was statistically significant. Among 23 patients with CHF, 16 had neutrophil counts >8500, but among 45 patients without CHF only 19 cases showed this value (Odds ratio=3.12, P=0.03). Also among 35 patients with neutrophil counts >8500, 24 patients had ejection fraction (EF) of less than 45% and 11 cases had EF>45%(P=0.015). Conclusion: In this study we found a direct correlation between neutrophilia on admission and the presence of CHF and echocardiographic left ventricular dysfunction in first 4 days of hospitalization. So the patients with high neutrophilia need more invasive treatments to reduce the possibility of CHF.
Sarie Golmohamadloo , Farzane Broomand, Mitra Asadi Afshar ,
Volume 5, Issue 4 (12-2005)
Abstract
Background & Objectives: Unintended pregnancy is a worldwide problem. Despite abundant efforts by lranian family planning authorities during the last decade, unintended pregnancy and its consequences such as infected abortions is still a common problem. The aim of this descriptive study was to examine the causes of unintended pregnancy in Kosar Hospital, Urmia. M e thods : In this descriptive-analytical study the data were collected from 330 unintendedly pregnant women (out of 1830 pegnant women) visiting gynecology unit at Koshar Hospital in Urmia in 1999. These subjects were interviewed to fill out a questionnaire. Statistical analyses were performed with SPSS using t-test and Chi-square. Results: 83.6% of the cases were illiterate and 96.36% were housewives. 59.69% of the cases were above 30 79.09% had 3 or more children. The subjects used the following prophylaxy. Methods: thads. Pills (40%), withdrawal (25.5%), IUD (10%), injection (6.4%), minipills (4.5%), condom (3.6%) breast feeding (2.7%), rhythmic (0.9%) and tubectomy (0.6%). The remaining 5.8% had not used any prevention methods. We found a significant correlation between aging and number of unwanted pregnancies (P<0.0001 r = 0.44) and a negative meaningful correlation between literacy and rate of pregnancy (P<0.0001 r = 0.39). Reasons for failure were irregular use of pills, minipills or condom (90% each), unfamiliarity with prevention affter forgetting to take the pill (0.77%), IUD extraction, interrupted use of DMPA method and incorrect use of breast feeding method. Conclusion: This study reveals that desptie available prevention methods, due to lack of knowledge irregular use and misconceptions about complications of prevention methods, the subjects used unreliable methods which are more likely to lead to failure. Therefore, new measures should be taken in family planning centers to increase awareness among women concerning risk of unitended pregnancy.
Masuood Naderpour , Yalda Jabbary Moghaddam ,
Volume 5, Issue 4 (12-2005)
Abstract
Background & Objectives: Acute otitis media is the second most common disease of childhood. With inappropriate treatment, it can progress to chronic otitis media which requires surgical intervention. Surgical treatment of chronic otitis media is based on the following two principles: complete removal of pathologic tissues and improvement of hearing level. Trauma to the inner ear cochlea (caused by suctioning, surgical drill and ossicular manipulation at the time of surgery) may cause sensorineural hearing loss. Even slight additional hearing loss can profoundly affect these patients. The objective of this study is to assess sensorineural hearing loss following surgery for chronic otitis media. Method s : This is a comparative, analytic and cross-sectional study performed on 100 patients admitted to ENT ward of Imam Khomeini Hospital in Tabriz between 2000 and 2002. The data were analyzed after being collected using pre and postoperative audiograms. Results: By comparing pre and postoperative audiograms, postoperative sensorineural hearing loss was found in 6 patients (6%) 5 of whom were female. The highest complication rate was seen following tympanoplasty with ossicular reconstruction. No cases of sensorineural hearing loss was found following radical and modified mastoidectomy. Conclusion: Any type of surgical procedures in the middle ear has the potential risk for acoustic trauma and consequent hearing loss. Because middle ear surgery is performed to improve the ear function, more attention should be paid to this risk. In our study ossicular manipulation played a major role in causing sensorineural hearing loss as a postoperative complication.
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.
Parvin Yavari, Uadollah Mehrabi, Mohammad Amin Pour-Hoseingholi ,
Volume 5, Issue 4 (12-2005)
Abstract
Background & Objectives: Breast Cancer is among the most common types of cancer in women which in case of early diagnosis and treatment can increase women’s chance of survival. This study was performed in two case and control groups. Methods: This case-control study which was based on hospital records was conducted on 303 breast cancer patients and 303 control women. The collected data were analyzed by SPSS using Chi-square. Results: The study revealed that there were significant differences between the cases and controls with regard to knowledge (p<0.001) and practice (p<0.001) of breast self-examination. 61% of the cases and 32% of the controls mentioned BSE as a necessary measure for the early diagnosis of breast cancer. 76% of the cases and 47% of the controls were not aware of the proper time for BSE (p<0.001). More than two-third of the subjects in each group did not know the proper time and the necessity of BSE in menopause and pregnant women and these was a statistically significant difference between two groups in this regard (p<0.001). Women in case group had done more frequently than controls (p<0.04). Moreover, the BSE intervals in two groups was statistically significant (p<0.01). There was also a significant difference between the reasons of refusing to do BSE in two groups (p<0.05). Subjects in neither group had regularly referred to a physician for examination and early diagnosis. Conclusion:Since the knowledge and practice of women and their referring to a physician for breast examination is inadequate, it seems necessary to devise educational program about doing monthly BSE and hold educational courses to promote women’s knowledge concerning the early diagnosis of breast cancer as well as its appropriate and regular performance.
Farhad Salehzadeh,
Volume 5, Issue 4 (12-2005)
Abstract
The term periodic fever and diseases classified under periodic fever, have particular situation in pediatrics. Periodicity and fever are the hallmark of these syndromes, though there could be other symptoms and signs in each syndrome. On the other hand, most of these syndromes have familial pattern. Since some of these syndromes are common in north-west Iran, the understanding and recognition of these diseases seems to be necessary. Nowadays at least seven periodic fever syndromes have been explained in pediatrics: The first one is FMF and the last and new one is PFAPA. The rest of them are: Hyper IgD, FCAS, Muckel- Wells, CINCA, and TRAPS.
Shahram Habibzadeh, Afshin Fathi , Homauoon Sadegi , Firooz Amani, Mahiar Gamari,
Volume 6, Issue 1 (4-2006)
Abstract
Background & Objectives : Sinusitis is inflammation of perinasal sinuses. Gold standard for diagnosis and etiology of bacterial sinusitis is a positive culture of punctured samples in sterile conditions, which is invasive procedure. This study was designed to compare the effects of clarithromycin versus amoxicillin on treatment of acute community acquired bacterial sinusitis in children. Methods: This study was conducted as a single-blind clinical trial, with 30 randomly selected patients in each of two groups (case and control). Acute sinusitis was defined as sinusitis not lasting more than 4 weeks. Inclusion criteria were defined as existence of post nasal septic drip or nasal prulent secretions plus at least 3 out of 4 conditions as follows: unilateral local pain on face or head, halitosis, deterioration of symptoms in recent 5 to 7 days and axillary temperature equal to or greater than 38 degrees centigrade. For one group of patients (group A) clarithromycin (KLACID) 15 mg/kg in two divided doses, and for another group (group B) amoxicillin 40 mg/kg in three divided doses, were administered. The collected data were analyzed by SPSS (rel 9) using Chi-square and t-test. Results: In view of response to treatment, 9 persons in group B (30%) and 26 persons in group A (86%) felt healthy on tenth day of therapy. The difference was statistically significant (P=0.001) using Chi-square test. Mean days before patients’ improvement was calculated to be 10 ± 0 (mean ± SD) days for group B and 6±1.9 days for group A. The difference was statistically significant (P=0.001). Conclusion: Despite relatively small sample size, the difference found between effectiveness of two drugs was significant (p=0.001). Thus clarithromycin can be used as one of the effective drugs in treatment of acute bacterial sinusitis.
Ali Hosein Khani , Magid Ali Asghari , Seid Yoosof Hoseini, Naiere Amini Sani ,
Volume 6, Issue 1 (4-2006)
Abstract
Background & Objectives: Benign prostatic hyperplasia is one of the most common diseases in males and Transurethral Resection of Prostate (TUR-P) is a standard method for its surgery. Distilled water is used to clean the field of operation from blood and debris. The overabsorption of this washing fluid can lead to hemodynamic disorders and neurological complications called TUR-P syndrome. Because of hemolysis and ATN, most of the urologists, nowadays, prefer to use non-hemolytic solutions such as cytol and glycine 1.5%. Distilled water is widely used in Iran. Replacing this water with a nonhemolytic and hypoosmolar solution with reasonable price such as manitol 3% seems reasonable. This study was carried out to campare manitol 3% with distilled water during TUR-P. Methods: In a double-blind randomized clinical trial, we studied 78 patients with BPH who were admitted to Shahid Moddares hospital in Tehran for TUR-P. These patients were allocated to disstiled water group and manitol 3% group. Na, K, Cr, BUN, CBC, U/A, U/C, 24 hr urine volume and creatinine were checked preoperatively to determine GFR, Na, K, BUN and CBC were checked right after, 4 hours after and on the morning after the operation. Clinical signs of TUR-P syndrome were recorded in the patients as bradycardia, hypertension and neurologic sign. Results : Mean age was 68.6 in distilled water group and 66.4 in the manitol group. Mean weight of resected tissues, mean volume of the solution used and mean resection time were 19.8 gr, 19 litre, 50.8 minutes respectively in distilled water group and 20.2 gr, 20.3 litre and 51 minutes in the manitol 3% group. These differences were not statistically significant. The difference between decrease in serum Na and serum osmolality was not significant in two groups, however, hemolysis rate in two groups was statistically significant (p<0.01). The incidence rate of TUR-P syndrome was 34% in the distilled water group and 18% in manitol group. This difference was not statistically significant. Postoperative creatinine increase was 0.625 mg/dl in distilled water group and 0.04 mg/dl in manitol group. This was not statistically significant. Conclusion: Regarding the role of distilled water in hemolysis and ATN and due to the unavailability of non – hemolytic solutions such as glycine and cytol in Iran, the use of manitol 3% soluion which is a cost-effective, non hemolytic and hypoosmolar solution is recommended.
Seid Hadi Hakim, Gahanbachsh Samadikhah , Samad Gafari , Azin Alizadeh ,
Volume 6, Issue 1 (4-2006)
Abstract
Background & Objectives: Thrombosis with high mortality is a serious complication of prosthetic heart valves and requires treatment, which includes reoperation or using filbrinolytic medications. Regarding the importance of the issue and high mortality rate in reoparation, the present study was performed to determine the efficacy and pragnosis of fibrinolytic therapy on mechanical prosthetic valve. Methods: This prospective study was preformed on seventeen patients with PVT who had undergone treatment with streptokinase (SK). After the primary diagnosis, the response to treatment was echocardiography and TEE. Patients with large clots or equal to 1cm clots, pregnant women and patients who had been operated in a month prior to the study were excluded. Results: Of the 17 patients (9 female and 8 male, mean age= 43.8 ± 11) 14 had mechanical double-let prostheses (8 mitral & 6 aortic) and 3 patients had single-let prostheses (1 aortic and 2 mitral). 71.3% of the patients with a double-let prosthesis responded completely to the treatment with SK. In none of the patients with a single-let prosthesis the treatment was successful. Also treatment of acute thrombosis was more effective in aortic position (71.4%) than in mitral– valve (50%) (p=0.02). Mortality rate due to cerebral bleeding was 5.8%. Two systemic embolic events (11.8%) occurred (1 cerebral and 1 renal) with transient signs. Conclusion: The use of fibrinolytic agents was effective, relatively safe and available especially in patients with less than two weeks’ presentation, small clot and NYHA class I and II and in aortic-position thrombosis.
Saeid Khamnei , Nahid Ghandchilar, Hooshang Najafi, Mahdi Farhoudi,
Volume 6, Issue 1 (4-2006)
Abstract
Background & Objectives: Many researches have been conducted on autoregulation of cerebral blood flow (CBF), but its possible variations coincidence with postvagal tachycardia have not yet been studied. The present study searched for the effect of this phenomenon on CBF in young and middle-aged persons. Methods: 52 healthy volunteers including 13 young males (mean age 23.9±0.8), 13 young females (mean age 24.2±0.7), 13 middle-aged males (mean age 58±0.9) and 13 middle-aged females (mean age 56.4±0.7) went under the study. Flow velocity in middle cerebral artery (MCA) was assessed using transcranial Doppler (TCD) ultrasonography apparatus. Eckberg’s neck suction device was utilized to stimulate carotid baroreceptors. The data were analyzed using Minitab and SPSS software (rel. 10). Results: Concomitant to the carotid baroreceptors stimulation there was a significant reduction in heart rate in all groups (p<0.05), but mean cerebral blood flow did not change significantly. After ending the carotid baroreceptors stimulation and concomitant to PVT, mean cerebral blood flow increased in all groups except middle-aged males. This increase in CBF became significant in middle-aged females (p<0.05). Conclusion: The results of the present study indicate that cerebral blood flow autoregulation act effectively concomitant to acute stimulation of carotid baroreceptors and this efficacy is maintained until the middle-age, but when faced with PVT, cerebral blood flow autoregulation dose not act effectively.
Behrooz Dadkhah, Mohammad Mohammadi, Naser Mozaffari ,
Volume 6, Issue 1 (4-2006)
Abstract
Background & Objectives: Since the students majoring in different fields of medicine are going to play key roles regarding community health in the future, it seems necessary to characterize problems threat e ning their mental health. This study was performed in order to evaluate students’ mental health status in Ardabil university of medical sciences. Methods: In this descriptive and analytical study, 426 students, selected nonradomly were requested to fill out General Health Questionnaire (GHQ) with 28 questions as well as personal information questionnaire. The data were analyzed using descriptive statistics and Chi-squre. Results: The findings indicated that fear to speak among peers (31.2%), lack of concentration (24.2%) and losing self-confidence (18.1%) were obsessing the students. According to cut point 23, 28.1% of students were assumed to have mental disorder. There was no significant difference between male and female students in terms of mental disorders but there was a meaningful relationship between their status and their economic problems, living place as well as their interest in their course (p<0.05). Conclusion: This study suggests further psychological evaluation and adequate counseling service to promote students’ mental health.
Hosein Doostkami , Adalat Hosseinian, Gholam Hosain Fatehi,
Volume 6, Issue 1 (4-2006)
Abstract
Background & Objectives: Coronary artery diseases are the leading causes of mortality and morbidity in industrial countries and in Iran. Myocardial infarction and unstable angina are essential clinical syndromes of coronary artery diseases, with the difference that the mortality and morbidity of NonST-elevated myocardial infractions is more than U/A and requires more intensive care. Rapid differentiation and diagnosis of NSTEMI from U/A plays a major role in effective treatment of patients and improvement of their prognosis. This study was designed to determine the incidence of nonST-elevated MI among patients hospitalized with initial diagnosis of U/A. Methods: This is a descriptive and analytical study performed on patients hospitalized with U/A diagnosis between 2001 and 2002 in Ardabil Buali hospital. The data (including demographic characteristics, patients’ clinical findings, ECG changes, laboratory findings) were collected using a questionnaire and analyzed by SPSS software using descriptive and analytical statistics. Results: mean patient age was 61 and prevalence of nonST-elevated MI among patients with U/A was 23 patients (22.1%). Mean age of patients with NSTEMI was 60.5 and its prevalence was greater in male (69.9%) than in female (30.4%). The most prevalent ECG change in patients was T wave inversion and ST depression (78.3%) and in U/A patients it was T wave inversion (60.5%). The difference was statistically significant (p<0.001). 64.7% of the NSTEMI patients and 27.4% of the patients with U/A had severe chest pain (p<0.004). Conclusion: Prevalence of NSTEMI was about 1/5 of patients hospitalized with diagnosis of U/A and ECG changes among these patients (as T wave inverison and ST depression along with negative T wave) is more prevalent compared to those with U/A. Clinical manifestation and complications were more severe in these patients than U/A group.
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