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Showing 582 results for Subject: Special
Manoogehr Barak , Firooz Amani, Mehrdad Mirza Rahimi , Nateg Abbasgholizadeh, Ali Reza Hamid Kholgh , Volume 5, Issue 1 (4-2005)
Abstract
Background & Objectives: Neglecting children can have irremediable and harmful effects on them concerning their growth, evolution, acquisition, and health both at present and in the future. Since lack of nutrition knowledge and failing to observe the principles of infant nutrition is one of the important causes of malnutrition and its unpleasant consequences, we decided to carry out an assessment concerning mothers’ level of awareness about infant nutrition and the factors affecting this knowledge, as well as the effect of this knowledge on growth and development of children. Methods: This descriptive-analytical research was conducted to evaluate mothers’ knowledge of infant and neonatal nutrition and its effect on infant growth in Hir health center. The data were collected using a questionnaire, including 20 questions, which was filled out in the health center. Moreover weight, height and head circumference of 100 infants were measured. The data were analyzed using SPSS software. Results: All mothers’ age ranged between15-36 and were housewives.15% were unlettered, 18% had high school education and others primary or secondary school education. 55% of children were female and 45% male. 67% of mothers had knowledge about proper neonatal and infant nutrition. 97% of them had little knowledge about when to start introducing different nutrients for infants, 3% had moderate knowledge in this regard. Conclusion: Regarding the findings of this study and the lower knowledge level of mothers about when to start giving different food to infants as well as the importance of proper nutrition in their growth, it is necessary to improve mothers’ knowledge and promote children’s health.
Gollam Ali Hamedbarghi, Afshin Mohammadi , Abdoll Rasool Safaeian, Volume 5, Issue 1 (4-2005)
Abstract
Background & Objectives: Patients in unstable condition with blunt abdominal trauma require rapid evaluation of abdominal organs to assess the need for laparatomy. Ultrasonography is a fast technique which can be used in the resuscitation area to detect free intraperitoneal fluid as an indication of intraabdominal injury. This prospective study was designed to determine the efficiency of emergency abdominal sonography for evaluating patients with blunt abdominal trauma and to compare the accrurcy of ultrasonography with the results of diagnostic peritoneal lavage and CT scan. Methods: Emergency sonography was performed prior to diagnostic peritoneal lavage and CT scan on 174 patients with blunt abdorminal trauma. Sonography was performed with FAST ( Focused Abdominal Sonography for Trauma) technique and six area of the abdomen where examined to detect free intraperitoneal fluid. Results: The results of this study revealed that ultrasonography has a sensitivity of 95% a specificity of 80.8%., and an overall accuracy of 89.4% for detecting free intraperitoneal fluid. The positive and negative predictive value of sonography was 89.4% and 90.1% respectively. Conclusion: Ultrasonography is a reliable method for the emergent evaluation of blunt abdominal trauma and can be used instead of diagnostic peritoneal lavage.
Shahram Habibzadeh, Shahnam Arshi, Nategh Abbasgholizadeh , Moharram Yusefisadat , Moharram Alimorad, Hosein Sadeghi , Hamid Jafarzadeh, Jafar Bashiri, Saeeid Sadeghiehahari , Firooz Amani, Roghaie Tafarrogi , Naiere Aminisani, Volume 5, Issue 1 (4-2005)
Abstract
Background & Objectives: In modern civilization, community participation is considered to be the most important way of development in different parts of the society. Establishing social development and health promotion centers (SDHPC) is the first step which is taken in this regard. In these centers, social development is implemented along with health promotion. During some planned activities people practice participation and having sense of responsibility while they move towards development and health. They understand that the key for solving majority of health problems are in their own hands. Methods: In the framework of an action research, interventions based on dynamic, reevaluation activities, were done in two parts: Formation of activity committees and establishment of population laboratory. SDPHC set its programs based on a planned approach to community health and community mobilization was the first practical action in this plan. Aiming at presentation and evaluation of community mobilization model, different activities consisting of mobilization of heath volunteers, raising participation of regional stake holders, recognizing social literature to ensure effective and pervasive communication with people, propagation and call for participation along with general enumeration of society was done to find authoritative people. Results: Health volunteers helped to recognize 60 key persons. 53 of them accepted participation. Objectives of the center were explained to them in three meetings, and their opinions were collected. A study of community literature showed that this region had a moderate to high cultural behaviors, and moderate to low income level and education with suitable interest in participation. The Evaluation of provincial broadcasting organization, municipality and other organizations was not desirable except for education organization. Publishing a newsletter was not welcomed by people but it created a bright perspective among governmental authorities. 287 persons accepted invitations voluntarily and took membership. After regional census, it was found that 4355 households with a total population of 19652 were living in this region 9305 (48%) of whom were females. Mean age of population was 26 and mean household dimension was 4.5. 8352 persons (42%) were married. Majority of women were house wives and majority of men had self managed job. Conclusion : The process of community mobilization in this project was evaluated to be successful but for establishment and continuation of activities in SDHPC most of the organizations and different groups of people should be encouraged to participate.
Hojat Hossein Pourfeizy , Airag Lotfiniya , Volume 5, Issue 1 (4-2005)
Abstract
Background & Objectives: Fat embolism syndrome (FES) is mainly due to the obstruction of blood vessels with fat globules, reached to circulation. FES is associated with traumatic and non traumatic diseases. The prevalence is 2-5% in long-bone fractures. The purpose of this study is to evaluate manifestations, laboratory findings and the diagnosed cases of fat embolism. Methods: In this retrospective study all the patient records associated with injury were evaluated and those diagnosed with the traumatic fat embolism were selected. The data including sex, age, type of fracture, clinical and laboratory findings and symptom onset time were collected using a questionnaire. These data were then statistically analyzed. Results: 17 out of 1660 patients were found to have fat embolism most of which belonged to middle-aged men. The most common clinical features consisted of: respiratory failure, tachycardia and consciousness level alterations. Fat embolism was mainly associated with tibial and femoral shaft fractures. Low level of Pao2 (Pao2<60) is the most reliable laboratory test in this study. Conclusion: Fat embolism should be regarded as a threarening factor in patients (especially middle-aged ones) with fractures in long bons of lower limbs. Pao2 Level of can also be used as a reliable laboratory finding.
Giti Rahimi, Volume 5, Issue 1 (4-2005)
Abstract
Background & Objectives: Hysterectomy is the most common surgery among nonpregnant women. A review of indications of hysterectomy can provide the specialists with new insights about these patients’ treatments. The aim of this study is to investigate the indications and methods of hysterectomy in patients referring to Alavi hospital. Methods: This cross-sectional study was done in Alavi hospital for two years (2002-2003). The data from 257 hysterectomized patients collected through interview and studying their records were entered into previously-designed questionnaires. The collected data were then analyzed using SPSS software. Results: The number of hysterectomies decreased 38.4% in 2003 compared to 2002. The mean age of patients was 45.8±8.09. The most common indication of hysterectomy was lyomyoma in 42.2% of cases. Abdominal hysterectomy and vaginal method were done in 93% and 7% of the cases respectively. In patients who were operated for pregnancy and delivery complications, the most common indication for hysterectomy was placenta increta (50%). The most common complication was hyperpyrexia (25.7%). The prevalence of complications of abdominal hysterectomy and vaginal method was 26.3% and 16.6% respectively. Conclusion: Lyomyoma is the most common indication of hysterectomy in patients referring to Alavi hospital. Besides, abdominal operation is the most prevalent method of hysterectomy in this hospital. Complications of vaginal method are less than those of abdominal method.
Saeid Mahmood Tabatabaei, Hosein Nematollahi, Faride Shakeri Manesh , Volume 5, Issue 1 (4-2005)
Abstract
Background & Objectives:Understanding children’s behavior and its affecting factors is the foundation for practicing dentistry for children effectively and, at the same time instilling a positive dental attitude into them. A number of studies have been done in this regard during the last three decades. This study is another attempt to find out proper strategies in order to control and optimize the diagnostic and trearment measures as well as to investigate the effect of mothers ’ personality characteristics on children ’ s behavior. Methods: The sample consisted of 104 randomly selected children (53 boys and 51 girls) at the age of 3 to 6 together with their mothers. The children had no previous dental experiences and no mental or physical disabilities entailing special care. Children’s behavior was assessed during three different dental visits according to Frankle ’ s Behavioral Rating Scale, in which four distinctive scales, namely absolutely negative, negative, positive and absolutely positive were precisely defined and scaled. The first visit was dental examination, the second was fluoride therapy and the last one was restorative dental treatment. Meanwhile, their mothers ’ personalities were determined through an interview conducted by a psychiatrist and based on DSMIV criteria and using General Health Questionnaire (GHQ) these personality characteristics were categorized in four groups: Normal, Depressed, Anxious and Obsessional. Results:The findings revealed that 12.5% of children had no cooperation during 3 visits, most of whom were 3 to 4 years old. The difference was significant compared to 4-5 and 5-6 year old children (p<0.05). In addition, sex did not influence children ’ s behavior. This study showed that children of mothers with obsessional personality were the most cooperative ones during the 3 visits compared to mothers with other personality characteristics. This difference was statistically significant at the first visit, (p<0.05). Conclusion: Mother ’ s personality has the strongest effect on children’s behavior during the first dental visit.
Kaviean Ghandhary, Mohammad Afshar , Volume 5, Issue 1 (4-2005)
Abstract
Background & Objectives: Demographic and environmental factors are effective in the pathogenesis and prevention of Parkinson Disease (PD). Sex, family history of PD, farming, literacy, history of head trauma, smoking, well water consumption, overusing oil seeds and contact with herbicides and pesticides are apparently effective in this regard. This study set out to investigate the risk factors of PD. Methods: 100 patients with PD and 200 age matched controls refering to Neurology clinic of Birjand UMS were investigated in this case-control study during 2002-2003. PD was diagnosed by a neurologist and the demographic and environmental factors were recorded in a questionnaire. Student T and Chi-Squire tests were used for statistical analysis. Results: 68% of the cases and 53% of the controls were male. Family history of PD, farming, literacy, stress and well-water consumption were significantly more frequent in PD group(p<0.05). Smoking and overusing oil seeds were more frequent in control group (p=0.007, p=0.001 respectively). Frequency rate of contact with herbicides, pesticides and history of head trauma were not significantly different in case and control groups. Conclusion: Family history of PD, farming, literacy, stress and well-water consumption are risk factors of PD, while smoking and using oil seeds could be protective factors against PD.
Nasrollah Maghamipour , Naser Safaii, Volume 5, Issue 1 (4-2005)
Abstract
Background & Objectives: Neurofibromatosis is a congenital disorder with different kinds of disabling manifestations. There are several types of operations for these manifestations with relative improvement. This study set out to determine age, sex, clinical manifestations and evaluate methods of treatment of these patients. Methods: This descriptive, cross-sectional study was conducted through studying the hospital records of patients who had previously undergone surgery. 45 patients with neurofibromatosis who were hospitalized and operated in surgical ward of Firoozgar and orthopedic ward of Shafa hospital from 1995 to 1998 were studied in terms of clinical manifestations and treatment methods. Patients with central nervous system involvement were excluded from the study. Results: 55% of the subjects were male and the rest of them were female. Most of the patients were in the second decade of their life. Skeletal abnormalities were seen in 35 patients (77.77%) and 16 patients (35.55%) were suffering from scoliosis which was the most common complication of this disease. With respect to the progression of the disease, brace was used in 2 patients, which led to their improvement. In 13 patients Horington Rod implantation was used, three cases of which developed scoliosis, who underwent surgical vertebral fusion. Pseudoarthrosis was seen in 8 patients (17/77%). Bone graft and plate were used in their operation. In five cases with pseudoarthrosis in lower limbs no ::union:: occurred. Two patients died with malignant shwanoma. Conclusion: scoliosis is the most common manifestation of neurofibromatosis which can improve in early stages with surgical treatment but pseudoarthrosis in lower limbs has not improved with bone graft and plate. Operation with pediculated fibula resulted in the improvement of this complication. Surgical intervention would be more effective in the early stages of the disease. 2 of thses 5 cases were reoperated with pediculated fibula graft and 3 others were amputated.
Javad Mikaeli , Mortaza Khatibian , Zohre Movahhedi, Hosein Gorbani Behrooz , Reza Malekzadeh, Volume 5, Issue 1 (4-2005)
Abstract
Background & Objectives: Cholangiocarcinoma is a malignant tumor of the biliary tract epithelium. Although it is not a common tumor, it has a high mortality rate so that the five-year survival of the patients is only 5%. Most patients are found to have irresectable tumor on initial presentation. These have led to an emphasis on the role of palliative treatment. Methods: 43 patients with Cholangiocarcinoma (from 1996-2003) based on ERCP were included in this study. Demographic aspects, clinical and Para clinical manifestations as well as the risk factors were investigated and survival rates of the patients were compared with or without stenting of the biliary tract. Results: 27 patients (62.8%) were male and 16(37.2%) were female with mean age of 65. Ulcerative colitis accompanied with PSC was diagnosed in just one case. Jaundice, weight loss and pruritus were the main complaints of the patients. Twenty-seven cases received stent in biliary tract through ERCP while no treatment was performed in other patients due to technical failure or patients’ disagreement. Mean survival time for all patients was 125 days. There were no statistically significant difference between survival rate of the patients with stent and without it. Conclusion: In this study cholangiocarcinoma in our patients was less frequently seen to accompany UC and PSC. Curative surgical resection is not possible in the majority of cases, and palliative treatment only decreases the severity of the symptoms but has no significant effect on survival.
Nader Pashapour, Mohamaad Hosein Hosseinianzakaria, Volume 5, Issue 1 (4-2005)
Abstract
Background & Objectives: Yogurt is recommended as a treatment for acute diarrhea. This study was conducted to determine the effect of pasteurized yogurt consumption on acute non-bloody and non-mucoid diarrhea in hospitalized 6-24 month old infants as compared with that of routine treatment. Methods: In a clinical trial study 80 children with 6 to 24 months of age with diarrhea for less than four days and were hospitalized in Urmia Imam Hospital, were assigned into two groups. The first group consumed yogurt containing streptococcus thermophilus and lactobacillus bullgaris 5 ml/kg per day while the second group received the routine treatment. Those suffering from malnutrition, bloody stool and diarrhea without GI source were excluded. Reduction of diarrhea frequency to half compared to admission time was regarded as response to treatment. Weight gaining, duration of admission and reduction of diarrhea frequency were compared in two groups. Results: The two groups were not significantly different in terms of age, weight and frequency of diarrhea at the time of admission. Mean hospitalization days, weight gaining, reduction of diarrhea frequency were 2.7±0.91 days, 435± 89.30 grams, and 4.30±1.74 times respectively for case group and, 3.1± 0.74 days, 383 ± 98.96 grams, and 3.60±1.23 times for control group respectively. No significant differences were observed between two groups regarding mean hospitalization days (P=0.035), reduction of diarrhea frequency (P=0.049) and weight gain (P= 0.017). Conclusion: Consuming pasteurized yogurt as a probiotic agent has a positive effect in treatment of acute nonbloody and nonmucoid diarrhea. Public use of yogurt is recommended.
Habib Ojaghi, Rahim Masoumi , Elham Ghaebi , Volume 5, Issue 2 (6-2005)
Abstract
Background & Objectives: Pterygium is a common ophthalmic disease which can cause astigmatism and restriction of visual field and cosmetic problems. Regarding the high recurrence rate using the common methods and because similar studies have never been done in Ardabil province, we decided to study the recurrence rate of pterygium after surgery with intraoperative application of mitomycin C. Methods: In this descriptive cross-sectional study all patients with primary pterygium who had undergone surgery between February 2001 and September 2003 were assessed and followed up for postoperative examinations. The findings were then statistically analysed. Results: In this study 83 eyes of 80 patients were examined. The highest prevalence of pterygium was in age group 31-40. Most of the patients had undergone unilateral surgery. In terms of size the most prevalence of pterygium was 3-4 mm. 4 cases (4.8%) had recurence one of which was observed in the first 2 months after surgery and three others in 2-6 months after it. In 50% of the recurred cases pterygium was 4 mm and in the rest of them it was 5 mm in size. After operation just 2 cases had granuloma which did not respond to topical corticosteroids and were excised by surgery. Conclusion: This study shows that the recurrence rate of pterygium after surgery with intraoperative mitomycin C is very low and this method has no serious complications. Using this method routinely is recommended. Moreover the recurrernce rate of pterygium is associated with its size.
Masuood Parish, Soosan Rassoli, Mohammad Reza Afhami, Farnaz Moslemi, Volume 5, Issue 2 (6-2005)
Abstract
Background & Objectives: Oculocardiac reflex (OCR) is presented with bradycardia and other arrhythmias, is induced by mechanical stimulation and therefore, encountered during strabismus surgery. The aim of this study is to determine the incidence and risk factors of cardiac arrhythmias during strabismus surgery in children and adults. Methods: In this prospective, randomized and double-blind study, 46 patients ASA class I and II underwent elective strabismus surgery with general anesthesia and were allocated to one of the two groups: children under 12 and adults over 12. All patients received standard general anesthesia based on their age. Demographic data, type of involved muscle, the incidence, (type and frequency) and the cause of arrhythmias and skillfulness of the surgeon (professor-assistant) were recorded. Results: There were 26 patients in children group and 20 patients in adult group. The overall incidence of arrhythmias was 91% with 96.15% in children and 85% in adults. There was not any significant difference in the incidence of arrhythmias, and the mean rate of occurence between two groups. Most of the arrhythmias were due to external ocular muscles traction. Conjunctival traction and pressure on the globe were the other causes. Stimulation of median rectus muscle as the most important arrythmogenic factor was seen in 13 children and 12 adults. Bradycardia and tachycardia were among common arrhythmias, but there was no significant difference between two groups (P>0.05) in terms of their incidence. Conclusion: This study showed that the incidence of arrhythmias during strabismus surgery is high in both children and adults. This reflex does not often lead to hemodynamic compromise, however, for its early diagnosis and treatment, close and continuous monitoring of the patient as well as cooperation and communication between anesthesiologist and surgon is needed.
Saied Javad Toutounchi, Parvane Abbaszadeh, Mahmood Barzgar , Volume 5, Issue 2 (6-2005)
Abstract
Background & Objectives: Hearing is perhaps the most important sense in human beings without which communication with the environment would greatly diminish. Chronic perforation of tympanic membrane, ossicular erosion and tympanosclerosis are major causes of hearing diorders. Nevertheless, a conducting hearing loss is the commonest complication of chronic otitis media. Cholesteatoma which is the most dangerous complication of chronic otitis media is treated by surgery. Tympanosclerosis is also one of the most important complications of chronic otitis media, which leads to conductive hearing loss through ossicular fixation. This study is an attempt to determine the effect of different kinds of chronic otitis media on the hearing of the patients. Methods: In this survey, 440 patients with chronic otitis media, who were surgically treated in the department of otolaryngology between 1998-1999, were studied in terms of various pathology of middle ear and the resultant level of hearing impairment. Results: 37 patients (8.4%) were involved bilaterally with otitis media. The number of operations on the left ear was 10% more than those on the right. The most common pathology recognized in examination was nonprulant perforation of tympanic membrane in 179 cases (40.7%) and the most common pathology recognized in surgery was cholesteatoma in 140 cases (30.2%). From 440 patients, 430 cases had conductive hearing loss and 92 cases (20.9%) had sensorineural hearing loss. Cholesteatoma of middle ear caused the highest proportion of conductive hearing loss and majority of the cases with sensorineural hearing loss (about 30%) whereas tympanosclerosis caused the most severe sensorineural hearing losses. Conclusion: The findings indicated that cholesteatoma and tympanosclerosis were the most common causes of both conductive and sensorineural hearing loss with tympanosclerosis as the cause of the most severe sensorineural hearing loss. However granulation tissue is the most common histopathology in patients with chronic otitis media at references and papers.
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.
Shahram Habibzadeh, Latif Gachcar, Mohammad Reza Masjedi, Ali Akbar Velayati , Volume 5, Issue 2 (6-2005)
Abstract
Background & Objectives: Some special characteristics of mycobacterium tuberculosis such as long time incubation period in culture media needed for colony appearance, unavailability of serologic methods for diagnosis, along with necessity of starting treatment in the patients with severe conditions as well as isolation limitations requires the introduction of rapid and innovative diagnostic tests. On the other hand, some diagnostic tests such as Polymerase Chain Reaction (PCR) require special experimental conditions which are not easily available to clinicians. This study was designed to determine the diagnostic value of serum adenosine deaminasae in pulmonary tuberculosis and evaluate its efficacy in pulmonary tuberculosis diagnosis. Methods:This cross-sectional study started in spring 2002. Continuous sampling was done and admitted patients were observed, examined and interviewed using a diagnotic test. All patients admitted with a suspected pulmonary tuberculosis diagnosis based on physical examination, history and chest X-Ray results were followed up for six months to ensure that mycobacterium tuberculosis infection was appropriately diagnosed. Blood samples were taken for serum ADA and complementary diagnostic tests. Following certain necessary tests and work-ups patients with or without tuberculosis were identified. Results: 131 Patients were evaluated completely. 103 had tuberculosis and 28 patients had other diseases. No statistically significant difference was found between mean level of serum ADA in two groups. But a serum level of ADA greater than 51 U/L was associated with 90% positive predictive value and specificity in differentiating two groups. Conclusion: Serum ADA is not a suitable test for pulmonary tuberculosis diagnosis.
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.
Jafari Rahimi Panahi , Ata Mahmoudpour , Sohrab Negargar, Rasool Azarfarin , Volume 5, Issue 2 (6-2005)
Abstract
Background & Objectives: One of the most common ways in intubation without muscle relaxant is using propofol and remifentanil. The common practice is injection of remifentanil and then propofol. This occasionally produces severe hemodynamic changes. The aim of this study is to inject propofol followed by remifentanil for evaluating the effect of the order of injection on decreasing these complications. Methods: 40 patients with American Society of Anesthesia (ASA) class I-II, who underwent minor elective surgery with airway mallampati class I-II entered the study. Patients were randomized into 2 groups each with 20 patients. The first group received 2.5mg/kg propofol followed by 1.5 g/mg remifentanil while the second group received 1.5 g/mg remifentanil followed by 2.5 mg/kg propofol. Laryngoscopy and hemodynamic changes were compared in two groups. Resutls: There was no difference between two groups in laryngoscopy attempts (P=0.145) but the frequency of easy laryngoscopy in the first group (85%) was more than the second group (60%) (P=0.031). Systolic blood pressure changes after laryngoscopy in the first group (20 7.7 mmHg) was less than the second group (28 6.7 mmHg) (P=0.001). There was no statistical significant difference between two groups in diastolic blood pressure and heart rate changes (P=0.88, P=0.86 respectively). Conclusion: Administrations of propofol before remifentanil during anesthesia induction produces acceptable hemodynamic changes in patients.
Kazem Sakha, Arman Malekian, Volume 5, Issue 2 (6-2005)
Abstract
Background & Objectives: Regarding the admitted cases at early infancy in Tabriz Pediatrics Medical Center, this research was carried out to determine the role of Hep.B. vaccination in the incidence of ITP. Methods: We studied all patients’ admission files in Tabriz Pediatrics Center from 1993 to 2002. The patients were under 6 months of age and hospitalized with the impression of ITP. There were 25 infants whose ITP was diagnosed upon their clinical findings, blood counts and bone marrow aspiration and confirmed by exclusion of other causes of thrombocytopenia. Hep. B. vaccination has been included in routine immunization in Iran since 1993. In order to compare the incidence rate of ITP before and after 1993, we also sought all ITP patients’ files at the same age group who had been admitted to Tabriz Pediatrics Center during the decade before the beginning of routine Hep.B. vaccination (i.e. 1982 to 1992). Results: This study shows a considerable increase in incidence of ITP in infants under 6 months of age between 1993 asnd 2002 compared to the decade before the beginning of Hep.B.vaccination, which is statistically significant (P=0.0029). Conclusion: Although there is no facility to measure antibodies in Iran and many other countries, and this is one of the reasons for lack of proof for existence of a relationship between vaccination and ITP incidence, the study of cases in two different periods may strengthen the role of Hep.B. vaccination in the occurrence of ITP at early infancy.
Homayoun Sadegi Bazargani , Shahnam Arshi, Ali Akbar Mortazazadeh, Jafar Bashiri , Naiere Aminisani, Saied Hashem Sezavar , Hasan Adalatkhah , Shahram Seifnejad, Ali Ruhi, Hale Shahlazadeh , Volume 5, Issue 2 (6-2005)
Abstract
Background & Objectives : Providing health services for all population subgroups of a community is a major hallmark for health administration. Little is known about health status of Ashayer population in Iran. This study aims at evaluating health status and quality of health service delivery to them. Methods: In a cross-sectional research 320 households (1800 persons), entered the study. Moreover, blood samples from 458 dogs were taken and studied with both Direct Aglutination Test (DAT) and a newly presented dipstick test . All children under 12 were also studied with DAT. In computing the sample size the generalizability for 63 variables with a minimum and maximum probability level of 90% and 97% respectively were taken into account and since the cluster sampling was employed, the Design Effect would be at least 1.56 and for different variables in the first sample it would be at most 4. Results: Only 30 households(9.7%) used piped water supply inside their houses while most of the other families (41%) obtained their water from mobile water tanks. Residual water chlorine was measured to be zero in 88.7% of the samples taken from drinking water of Ashayer. 89 (27.8%) households had lavatories and 22 (7%) households had bathrooms inside their houses. 90.4% of those using raw vegetables washed them only with plain water. Monthly incidence rate for accidents was 230 per 10000. 18.1% of women in reproductive age had a history of abortion. Unwanted pregnancy rate was 38.9%. 47.1% of women with a labor history in past three years had never been visited by any person legally allowed to do so. Women in reproductive age had a poor knowledge about contraceptive methods. The minimum delay for vaccination was 16.9 (SD= 19.26) days regarding the third dose of OPV and the highest delay in vaccination was 46.44 (SD=60.7) days belonging to the third dose of HBV. From all 503 persons above 12 years old, 77 cases had hypertension. Periodontal easy bleeding was observed in 13.7 % and pyorrhea in 19.3%. 10.2 % had aching neck, 18.7% had backache and arthralgia was shown in 13.5%. The unmet need for physician's visit was 64.8%. The frequency of positive cases of leshmaniasis was 3.4% and 3.06% for boys and girls respectively. 28 male and 6 female dogs were positive in DAT test making an overall positive rate of 7.4%. Sensitivity of dipstick test was higher than 80 percent only when golden standard was considered to be DAT ≥ 1 /640. Conclusion: Many of the health indices of Ashayer except for vaccination were suitable. This requires further attemps on the part of govermental and health outhorities. Kale-azar disease can spread to the north of the province as well as the neighboring provinces due to the migration of these tribes. It is predicted that Bilesavar and Parsabad cities will be added to the andemic regions of this disease in coming years. Using dipstick test recently offered by WHO is recommended to be used to screen the infected dogs.
Shahnam Arshi , Homayoun Sadeghi , Shahram Seifnejad , Parviz Salemsafi, Mehrdad Biria , Volume 5, Issue 2 (6-2005)
Abstract
Background & Objectives: The unsatisfied demands of employees can present itself in different forms such as lower output, efficacy, effectiveness and aborted objectives of the organization. Periodic evaluation and investigation of the demands of staff can increase satisfaction and motivation among them. Methods: In this descriptive-analytical study stratified systematic sampling was used for selecting the employees both with and without academic education. The total sample size was 615. The data were collected by means of a two-section questionnaire and analyzed by EPI Info 2002 and SPSS (ver.11) statistical packages. Results: 23.2% the staff members were not satisfied with their job. 26.9% of those bearing an academic cerrtificate were not happy with their field of study. 63% of the personnel were not satisfied with the health authorities’ attitude towards their welfare state. There was a 51% dissatisfaction regarding the concern about the issues related to the staff. There was also a 44.2% of dissatisfaction among the staff members about the performance of the related deputies. 35.9% of the personnel were not satisfied with their manager about paying attention to their problems. The staff requirements were graded as follows: self-actualization, respectability, social belonging, security and physiologic needs. There was a reverse relation between the personnel satisfaction and level of management. The findings indicated that the staff were more satisfied with their direct manager (64%) compared with university administrations (49%). There was a significant relation between the personnel satisfaction and their level of education (p<0.05). The relation between satisfaction with organization performance and sex was not statistically significant. The findings indicated a significant relation between type of education and different levels of personnel’s needs. The relationship between satisfaction and Maslow’s hierarchy of needs was investigated using Chi-square test, which indicated a statistically significant relationship only between group D needs and job satisfaction (p<0.05). Conclusion: Staff satisfaction with university administrations of Ardabil university of medical sciences and health services was low. Moreover, the self-actualization and self-esteem needs were of high priority among the employees.
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