Journal of Kerman University of Medical Sciences
Year:2009 | Volume:16 | Issue:2|Papers Count:11

Background & Aims: [alpha] 1-Adrenergic blockers have recently been shown to increase the rate of spontaneous passage of distal urethral stones. In this study the clinical role of Terazocin and Prednisolone in expulsion therapy of symptomatic distal urethral stones was assessed. Methods: The total number of 106 patients between 20-68 years old (Mean 39.05 years) who had lower ureteral stones with size of 5-10mm were selected in this prospective study. The patients were randomly divided into 2 equal groups; treatment group received Terazocin (5mg daily) plus Prednisolone (5mg daily), and control group received only analgesics. Hydration was recommended simultaneously. The treatment duration considered for 10 days to prevent the side effects resulting from prolonged corticosteroid therapy.Results: Two groups had no significant difference based on age, sex and stone location. In treatment group mean stone diameter was 7.45±1.705mm and in control group it was 6.7±1.75mm. The rate of expulsion for the treatment and control groups were 62.3% and 37.7% respectively that showes a significant difference between two groups (P<0.001). In the treatment group the number of pain episodes and analgesic (Morphin) intake was found to be lower compared to the control group. Conclusion: Simultaneous administration of terazosin ([alpha] 1-Adrenergic blocker) and Prednisolone (corticosteroid) can increase the frequency of spontaneous passage of distal urethral stones.

Background & Aims: 1,25-dihydroxyvitamin D3 (1,25 (OH)2 D3), the biologically active form of vitamin D, exerts an immunosuppressive effect through binding to its specific nuclear receptor. The present case-control study was done to examine the possible association of BsmI polymorphism in vitamin D receptor gene (VDR gene) with severity of multiple sclerosis (MS). Methods: 267 Iranian patients with MS and 292 ethnically and sex matched controls were included in this study. BsmI polymorphism in VDR gene was assessed by PCR-RFLP method. Results: No differences in the allelic distribution were observed in the patients as compared to the controls. Also no difference in genotype distribution of VDR-BsmI polymorphism was observed between patients and controls (p=0.43). Conclusion: Considering the significance of vitamin D3 as an immune system regulator and its inhibitory effects on MS, investigation on other VDR gene polymorphisms is recommended.

Background & Aims: Etiologically the causing factor of carpal tunnel syndrome is not clear and multiple contributing factors such as the presence or absence of Palmaris longus tendon have been cited. The aim of the present study was to compare patients with carpal tunnel syndrome and healthy individuals in regard to the absence and presence of Palmaris longus and fifth flexor digitarum superficialis tendons. Methods: This prospective study was performed on 60 diseased and 180 normal hands. Presence or absence of each tendon was determined carefully by the same examiner in both groups. Data were compared by Chi-square test. Results: The relationship between carpal tunnel syndrome and the absence of Palmaris longus tendon and fifth flexor digitorum superficialis was significant (P=0.041 & P=0.05 respectively). Carpal tunnel syndrome group compared to the control group had higher rate of the absence of both tendons in one hand (P=0.017) and lower rate of the presence of both tendons in one hand (P=0.005). By considering only the hands with Palmaris longus tendon, there were more cases of absence of fifth flexor digitorum superficialis in carpal tunnel syndrome group (P=0.048), but by considering only the hands with fifth flexor superficialis, there was no significant difference between the two groups in regard to the presence of Palmaris longus  tendone. Conclusion: It seems that the absence of Palmaris longus tendon and fifth superficial flexor each alone and in combination is a risk factor for development of carpal tunnel syndrome. Probably the absence of superficial flexor is a greater risk factor than the absence of Palmaris longus.

Background & Aim: Medicinal plants are used in traditional medicine for the treatment of different diseases such as hypertension. Since inhibition of angiotensin converting enzyme (ACE) is one of the involved mechanisms in control of hypertension, in this study the inhibitory effect of 20 medicinal plants on ACE was investigated.Methods: The medicinal plants were collected, powdered, extracted, lyophilized and kept in -20º C. ACE activity was assayed with hyporyl L histidine L leusine (HHL) as substrate in the micro scale. The extracts that inhibited 50% of ACE activity in comparison to control were considered as probable ACE inhibitors.Results: From 20 medicinal plants in this study, the highest ACE inhibitory effect (100%) was related to Alcea digitata (Boiss.) Alef., Rubia tinctorum L. and Cerasus avium (L.) Monech. Citrus aurantium L., Berberis integerrima Bge, Peganum harmala L. and Allium sativum L. also inhibited ACE activity equal or more than 70%.Conclusion: Since the highest ACE inhibitory effect was observed for Alcea digitata (Boiss.) Alef., Rubia tinctorum L. and Cerasus avium (L.) Monech, this plants can be used in further studies for separation of their active components against ACE activity.

Background & Aims: Methadone maintenance therapy is one of the treatment choices for opiate users. Understanding opiate dependants’ experiences of their treatment period is important for continuing the treatment with methadone and assessing their experiences may help to revise the standards of methadone centers and thus to improve the quality of treatment. This study aims to describe the structure and essence of opiate dependants’ experiences with methadone centers during treatment. Method: It was a qualitative phenomenological approach in which participants were selected from opiate dependants referred to methadone centers in Kerman city in 2007 by applying purposive sampling continued until data saturation and obtaining a sample size of 32 participants. Data were collected by in-depth interviews. Colaize’s Method was applied for data analysis. The rigor of the present study was based on transferability and credibility. Results: In whole, 26 themes were extracted and put into structural components. The structural components were put into topical components including: 1- positive therapeutic alliance 2- negative therapeutic alliance and 3- therapeutic alliance requests. These components show the basic structure of participants’ experiences of therapeutic relationship in methadone centers. Conclusion: Client–based strategy in methadone clinics, not only leads to a positive therapeutic alliance, but can persuade patients to continue their treatment programs for long time period. Establishing a good relationship with patients in methadone centers during treatment procedure is an effective way to meet the goals of methadone maintenance treatment.

Background & Aims: Occupational accidents are known as one of the most important causes of disabilities and mortality in developed and developing countries. Construction industry is one of the most high risk occupations which its hazardous are not known completely. In addition to occupational accidents, construction workers are faced many diseases factors such as asbestos, silicon, fumes and noises. The aim of this research was an epidemiological study and determination of a model for estimating accidents of instructor industry by the year 2011 in Yazd city. Methods: This study is a descriptive, analytical and distribution modeling. The questionnaire contained the variables of age, occupation, type of accident, injured part and the results of accident. Results: In this research 247 construction workers injured along five years in Yazd were studied. Most of the injured workers had worked less than one year (34.8%) and 12.55% had worked more than 20 years. Fatal rate of workers with no insurance was significantly more than those who had insurance (p<0.01). The most prevalent accident was falling (48.58%) and the less was chocking (2%). The highest level of injury was in hands and feet (27.53%) followed by head injury (22.27%). The relationships of accident results with occupation and also part of body were statistically significant (P<0.001). More than 51% of head injuries lead to death. After testing many models, time series model of quadratic form was found to be the closest model to the trend of data. Conclusion: According to time series model estimation, with this trend the rate of occupational injuries would be more than 300 cases by the year 2011 and this recommends serious measures for prevention.

Background & Aims: Immunodeficiency virus (HIV) may lead to acquired immunodeficiency syndrome (AIDS) in human. Parasites are one of the most important causes of infectious diseases in patients with AIDS. The prevalence of these parasites varies based on the condition of host’s immune system and the stage of disease (HIV/AIDS). To compare the prevalence of opportunistic intestinal parasites a cross-sectional study was carried out on 306 HIV positive and AIDS patients in Khorramabad city.Methods: After selecting the samples by census and availability sampling methods, planned questionnaires were completed and three stool samples were collected from patients. Then direct smear, formalin-ether concentration techniques and modified acid fast (Kinione) and modified trichorome staining methods were carried out on all samples during 2006-2007. Moreover the relationship between different variables and infection by intestinal parasites were examined. For description and statistical analysis t-test and Chi-square test were used.Results: The prevalence of intestinal parasites in HIV-positive and AIDS patients was 19.6% and 50% respectively. There was a significant relationship between HIV /AIDS and species of intestinal parasites (P<0.001).Conclusion: Higher prevalence of intestinal parasites in patients with AIDS compared to HIV-positive individuals indicates higher immune system deficiency and more susceptibility to intestinal parasitic infections (specially opportunistic parasites) and reflects the necessity of prevention, screening, diagnosis and treatment programs for these patients.

Background & Aims: Abuse of topical anesthetic drops causes serious ocular complications. Obtaining information about the prevalence of anesthetic drops abuse among high risk groups specially welders is necessary for taking appropriate strategies for prevention. The present study aimed at determining the prevalence of anesthetic drops abuse among welders in Kerman.Methods: In this cross-sectional study, 390 welders selected randomly were asked for the consumption of anesthetic drops by using a questionnaire. Data were analyzed by SPSS 11.5 software.Results: In whole, 314 ones (80.5%) said that they use tetracaine and of whom 295 ones (93.9%) had used the drug frequently. Lack of time for referring to Physician, high cost of visiting by physicians, spontaneous relief of symptoms and no other therapeutic measure by physicians were the most important reasons of self-treatment in welders. In whole, 216 ones (69.3%) had heard about these drugs from their coworkers, 85 ones (27.2%) from physicians, 51 ones (16.3%) from pharmacy personnel and 9 ones (2.9%) from their family members. The prevalence of abuse was significantly higher in those with post secondary educational level (P<0.05). Most of the subjects (97.4%) had got the drugs from pharmacies and without prescription. Conclusion: High prevalence of anesthetic drops abuse among welders and probably other similar jobs and educated people, their prescription by general practitioners and their selling in pharmacies without prescription requires more serious measures for prevention.

Background & Aims: Accurate knowledge about gestational age is very important in taking decision for pregnancy management and termination. According to Naegele’s rule the length of pregnancy is 280 days after LMP and according to studies performed in Harvard University, duration of pregnancy in nullipare and multipare women has been respectively 288 and 283 days and according to a study performed in Oxford University it is influenced by factors such as age, parity, some illnesses and personal habits. Materials and methods: In this retrospective study, all laboring women admitted in Ahwaz Medical University Hospitals in 2007 including 689 nulliparas and 774 multiparas with true labor pain and reliable LMP were studied for pregnancy duration. Data were analyzed by SPSS software. Results: Mean duration of pregnancy was 273.17, 274.31and 273.77 days in nulliparas, multiparas and overall respectively. Parity has no significant association with pregnancy duration. According to the sonography below 26 weeks duration of pregnancy is calculated 270.07 days which had no significant relationship with LMP.Conclusion: According to this study parity has no effect on pregnancy duration. Mean pregnancy duration was shorter comapared to Naegele’s rule and Harvard University studies.

Campylobacter jejuni is a Gram negative, curved, motile, thermophilic and microaerophilic bacillus in Campylobacteriaceae family, which is one of the main causes of enteritis in human named campylobacteriosis. The main reservoir of Campylobacter jejuni is the alimentary tract of animals, especially chicken and turkey. Consumption of semi-cooked chicken meat, raw milk and unchlorinated water are the main routes for the transfer of this bacterium to human and causing campylobacteriosis. Two to 5 days after ingestion of contaminated food the symptoms of campylobacteriosis including fever, abdominal pain and diarrhea appear. In this food infection vomiting usually doesn’t happen and diarrhea may end to dysentery. To control this food infection, meat should be cooked completely and consumption of raw milk and unchlorinated water must be avoided.