Annals of Military and Health Sciences Research
Year:2007 | Volume:5 | Issue:1 (SERIAL NUMBER 17)|Papers Count:21

Background: Hyperbilirubinemia is a common problem in neonates but sever hyperbilirubinemia will cause kernicterus. The aim of this study is to evaluate the efficacy of oral clofibrate in treatment of indirect hyperbilirubinemiain non hemolytic jaundiced full term neonates.Materials and Methods: In one clinical trial study were evaluated 60 healthy full term neonates with nonhemolyticjaundice. 30 neonates (control group) received only phototraphy while the other 30 neonates treated with single oral doses of clofibrate (100mg/kg) with phototraphy. Two groups were compared by the mean plasma total and indirect bilirubin after treatment and duration of hospitalization and need for exchange transfusion.Results: Total and indirect bilirubin levels after treatment showed that decreasing amount of total and indirect bilirubin within time in clofibrate - treated group significantly is more than control group. also the average duration of hospitalization and need for phototraphy on clofibrate - treated group is lower than control group. In the studied neonates with a single dose of clofibrate no side effects were observed during hospitalization and after discharge.Conclusion: up to now many pharmacological agent have been used for prevention or treatment of neonatal jaundice. Drugs such as Phenobarbital, Activated charcol and plain agar and metalloporphyrins have been used for this purpose but None of this drugs has been accepted completely by efficacy and safety and not available for routine use. Clofibrate due to its ideal efficacy in decreasing bilirubin and duration of hospitalization and oral easy use and availability of this drug is considered to be suitable treatment way for neonatalnonhemolytic jaundice.

Background: The borderline or low malignant potential category of ovarian tumors was established because of the observation that a group of proliferative epithelial ovarian tumors lacking invasion that generally behaved in a benign fashion. The purpose of this study is determined the effects of different prognostic factors on survival and relapse of serous borderline tumors that is the most common histologic type.Materials and Methods: 15 patients with previous diagnosis of SBTsenter a survival study and evaluated for the presence or absence of necrosis, associated inflammation, micropapillary/cribriform, FIGO stage and treatment procedure on two clinical conditions of overall survival and disease free survival.Results: The mean age at the time of diagnosis was 35 years (range, 16-68). The histopathological diagnosis was typical SBTs in 6 patients (40%), SBTs-IEC in 4 patients (20%), SBTs-Mp in 4 patients (26%) and finally SBTs-mi in 2 patients (13.3%). Statistically difference in the age (P- Value = 0/58) and size (P-Value 0.68) were not found to be significant. Thirteen patients have stage=1 (87%), two patients (13%) had stage>1. The recurrence rate was found in 7% (1 case). The overall survival was 100% and the disease free survival was 93%. After analysis just a statistically significant relation between high stage, necrosis and mitotic index 10/HPF and disease free survival were obtained (P-value = 0/016). We did not achieve to statistically significant relation between others histologic feature and disease free survival and In conclusion overall survival.Conclusion: Serous low malignant potential tumors have excellent survival and the patients can be treated safely by conservative surgery. The effect of FIGO on survival is consensus when the effects of others factors there are many controversies in the literature. Thus due to imitation of our number of case in each subgroup studies with adequate samples and long follow-up is recommended.

Background: Epidemiological evidences have showed that low back pain fallowing load-carrying is the most common disorder in musclo-skeletal system and is common in industrialized countries. Moreover, little is known about how muscles are recruited when several option of the accomplishment of task are available. Thus this study aimed to examine the effects of external load and trunk posture on the electromyography activity of trunk muscles.Materials and methods: 10 healthy women with no history of low back pain were enrolled in this study. Two inclinometers and five channel EMG system were used to evaluate the right trunk muscle activities (rectus abdominis, internal & external oblique, erector spine, and multifidus). Six static tasks while holding three levels of load (0, 6, 12 Kg) in two trunk position (neutral and 30 degree of flexion) were simulated for subjects.Results: With highest external load, the electrical activity of back and abdominal muscles increased significantly and with highest trunk flexion, the electrical activity of back muscles increased significantly (P<0.05).Conclusions: Co-contraction of back and abdominal muscles occurred in response to greater need for biomechanical stability. The increased extensor muscles activity during trunk flexion is necessary for stability and controlling of flexion.

Background: Traditional treatments for diabetes with natural plants and or its derivatives such as cinnamon are knew throughout the world. The assessment of cinnamon bark on decreasing blood glucose treated by insulin in male streptozotocin-diabetized rats.Methods and materials: 40 male rats with average weight of 220 gr. were divided into four groups of 10: Control group, was took only water and regular food. Diabetic group which is diabolized with 40 mg/kg intraperitoneal streptozotocin. Diabetic and insulin group was treated by insulin NPH (5U/kg) after diabolized by streptozotocin. Diabetic and insulin and cinnamon group was co-treated with insulin and oral cinnamon suspension. Plasma glucose was assayed using a glucose oxidize method.Results: In cinnamon group, the blood sugar was decreased significantly more than insulin group (p<0.01).Conclusions: It is suggested, the bioactive compound(s) from cinnamon (probably MCHP-Methyl Hydroxy Chalcone Polymer) may potentiate the function of insulin in cinnamon group. However, the bioactive product(s) of cinnamon might provide a natural remedy against diabetes in future.

Background: Alopecia Areata is a prevalent inflammatory chronic disease which %2 of general population is suffering from it. All current therapies of the disease have their own limitations, so the object of this study is to evaluate efficacy of combination therapy with local %0.5 Antralin and %2 minoxidil solution in treatment of alopeciaareata.Materials and Methods: In this placebo-controlled clinical trial, 53 subjects were included. 26 patients received combination therapy for 30 days, they used local %0.5 antralin 20 on their lesions 20 minutes every night, and after washing and drying the area used %2 minoxidil solutions the same night and next morning. The rest 27 patients used placebo on their lesions. At the end of study, their hair growths were measured by assessing terminal hair growth.Results: There were 53 subjects with mean age of 18.35±4.23 (%60.4) of the patients were men and the rest%39.6werewomen. The drug were more effective than the placebo (%67.9vs %32.1, P=0.063). Erythema and hyperpigmentation were seen in %96.1 and %100 of patients receiving drug, respectively, while just %29.6 of the placebo group had erythema and no one had hyperpigmentation.Conclusions: Most patients who used combination therapy took benefit of the drug and it seems that by increasing number of subjects and continuing the treatment, the rate of efficacy will increase considerably.

Background: The toxicity of many chemical substances has been studied by many of living organisms used as biological indicators. Higher organisms (laboratory animals) are generally used but the response time may be lengthy. Never the less by exploiting uni cellular organisms, in particulary yeast, it is possible to reduce testing time considerably. In this study, the budding yeast, saccharomyces cerevisiae asimple non-pathogenic eukaryotic organisms, which is easy to cultivate, has been used as experimental model for assaying acute toxicity of chemical substances.Material & Methods: As a experimental study, The first step yeast cells were cultured in broth media and correlation cell of numbers and optical density was determined in 525 nm. Then, yeast cells were cultured in the presence of various concentration of chemical substances and cell density was measured. the proliferation rate determined from the logarithmic growth phase. A dose-response curve was obtained by plotting the relative growth rate versus the chemical concentration which concentrations leading to 50% inhibition of growth (IC50) was determined.Results: the results showed a concentration - dependent cytoxicity effect for saff flower extract (IC50=1121 mml-1) and peganum harmala extract (IC50=476 mgml-1).The toxicity effects of dihidropyridine derivatives was studied up to 100 mMml-1, but no cytotoxic effect was observed.Conclusion: these results were agreement with other cytotoxic tests (Le, rat, hamster, brin shrimp, and human cell cultures) then this procedure can be used as the first step, for assaying acute toxicity of chemical substances.

Background: Hypertensive disorders in pregnancy are one of the high risk pregnancies. There are considerable evidences about the role of platelet in preeclampsia in pathophysiology. In this study the mean of volume platelet and count in normal pregnant women and preeclamptic women were compared.Materials and methods: In a case - control study 35 normal pregnant women who matched in age, gestational age, and gravity were compared with 35 preeclamptic women to determine the mean volume platelet and count from 2003 to 2005 on pregnant women who admitted at obstetric ward of Taleghani Hospital and outpatient department were entered the study.Results: Totaly 70 pregnant women (35 case of preeclamptic women and 35 control groups), were evaluated. Mean age in normal pregnant women were 27I 5.4 years and in preeclamptic group was 27.2±5.3 years (range: 17-38 years). The Number of gravity of the patients Were between 1 to 8.the mean of gestational age in both group were 32.7±5.1 weeks (range: 20-41 weeks). In normal group no one has platelet count less than 150.000/ml and in none of them means platelet volume was more than 10fm. In preeclamptic group in 16(45.7%) cases platelet count was less than 150000/ml and in 9 (25.7%) mean platelet volume of ³10fl was obtained. In normal pregnant women mean platelet count was 208300/ml±4600 and mean of mean platelet volume was 8.2±0.63fl. In preeclamptic women mean platelet count was 154000/ml±84000 (P<0.005) and mean of mean platelet volume was 9.2±0.84 fl. (P<0.0001).Conclusion: Decrease in count and increase in size of platelets probably precede preeclampsia.

Background: PTSD (Post Traumatic Stress Disorder) was happened in who was put in fearing or helplessness situation against the danger occurrence and effort to avoidance it. This symptom may was began after event and affected all of the person's life. This study was design to determine of PTSD prevalence in conscript and official staff of NEZAJA in Tehran by 2005-6.Materials and methods: This cross sectional study was done on 355 conscript and official staff of NEZAJA Garrison. Clustered stratified sampling was done to select the samples. PTSD was diagnosed on DSM-IV-TR criteria by psychologists. The obtained data was analyzed using SPSS11.5.Results: Age average of conscript and official staff of NEZAJA was 20.68 years old and the average mean duration of their employment was 24 month. Prevalence of PTSD disorder in Conscript and official staff of NEZAJA was 14.9%. The most common cause of the PTSD was motor accident (30.2%), explosion (9.4%). The patients had more age and mean time of employment. (P<0.05).Conclusion: Prevalence of PTSD disorder in Conscript and official staff of NEZAJA was 14.9%. It is advised to reduce conscription period time, enhance safety standard and increase professional education.

Background: The purpose of this research is to evaluate mental health of medical students to estimate prevalence of psychiatric disorder (including: Somatic symptoms, anxiety-insomnia, social dysfunction and depression) in this population: Nonmilitary medical students at clinical training grade referred to army university of I.R.O.I for instruction in 2nd half year of 1383.Materials and Methods: In this research 205 students (60% female, 40% male) were evaluated by GHQ- 28 instrument and also an enclosure containing demographic data.Results: The results of this research demonstrated that 47/8% of individuals were suspicious to mental disorder in which more frequencies were among women, interns, single marital status and those who had positive history of mental disease in their families.Conclusions: There was statistically significant relation between 1-Mentaldisorder and single marital status and also positive family history2-Somaticsymptoms (38.5%) and gender (female)3-Anxiety-insomnia(47.8%) and gender (female) and also FH(+)4-Social dysfunction (69%) and training grade (interns)5-Depression(25.4%) and single marital status and also FH(+)There was no significant relation between two groups of age (>25 Years) and non of considered disorders.

Background: Powerlessness has become endemic among most nurses in their work setting, as the result of inappropriate distribution of power in hospitals, allocating power to only a few, at the top of hospital hierarchy imposing it. The objective of this study is determining the relationship between nurse's perception of their head nurses empowerment behaviors and their own work effectiveness.Material and methods: 194 registered nurses occupied in three teaching hospitals of Baqiatallah, Jamaran and Najmieh that had been working more than 1 year of nursing experience and had not experienced the managerial practice entered the study by stratified random sampling in 2005. This study is a cross-sectional & correlational survey. "Leader Empowering Behavior" scale with 27 items (a: 0.82) and "Global Work Effectiveness" scale with 24 item (a: 0.89) was used. Self reported questionnaire completed by nurses outside their work setting.Results: Nurses in this study obtained a high score in L.E.B. scale (5.08+1.2) and also in G.W.E. scale obtained the moderate score (4.94+0.749). "Confidence in the employee" rated the most empowering leader behaviors (5.34+1.24) and "autonomy from bureaucracy" rated the lower behavior (4.94+1.31). For subscales of G.W.E. most their work effectiveness related to "clinical care role" (5.37+0.752) and lower their work effectiveness related to "researcher role" (3.96+1.1).Conclusion: Results showed that there is a relationship between head nurse's empowering behaviors and staff nurses work effectiveness perception. This finding points out the organizational managers that have an important role in increasing work effectiveness through empowering leader behaviors. To gain an obvious understanding of work empowerment concept, more survey is suggested.

Background: There are some methods to detect toxoplasma in infected patients. In this survey we compared sensitivity of two methods of IFA & ELISA.Material & methods: In this survey the sera of 106 newborn infants from 1 day to 1 month age who were suspected to congenital toxoplasmosis and were hospitalized in infants' ward of Taleghani hospital were evaluated for IgM and IgG specific antibodies with ELISA and IFA techniques respectively. At the same time blood/CS For both of them were evaluated for genome of this parasite by PCR techniques in 115 suspected infants.Results: Results of PCR were positive in 6 infants (%5.22) which suggested congenital Toxoplasmosis. The 1/100 titer of IgM specific antibodies was positive in 5 or them by IFA technique. If we suggest that PCR is gold standard technique for Toxoplasmosis diagnosis so the sensitivity of 1/100 titer of IgM antibodies by IFA technique would be 83.3 percent and because no other infants had a positive result so the specificity of this test would be 100 percent.Conclusion: All 6 infected infants had a positive result from ELISA technique for IgM specific antibodies so the sensitivity of this test was 100 percent. Because no other infants had a positive result, so the specificity of this test was 100 percent. 41 infants had 1/200 titer of specific IgG antibodies by IFA technique. With deletion of 6 infected infants, the prevalence of chronic toxoplasmosis between the mothers whose infants was confined in Taleghani hospital was 34 Percent. This prevalence was 30.2 percent by ELISA technique. Therefore IFA method is more sensitive than ELISA method in detection of toxoplasma gondi.

Background: The aim of this study is to assess the frequency of varicucele at asymptomatic soldiers and effect of varicucele on the spermogram. Varicucele prevalence in population is 15%.Materials and Methods: This study is cross sectional was performed on the 1275 soldiers after physical exam and preclinical exam 165 cases had varicucele.Results: This was a cross-sectional study. 118 subjects had varicucele grade 1(71/5%), 33 subjects grade 2 (20%) and 14 grade3 (8/5%). The results of motility were: uper 60% was 86% and lower 60% was 13.9%. morphology was: lower 20% abmormality was 96.9% and upper 20% of abnormality was 3.1%. In this study prevalence of varicucele was 13.5% in the asymptomatic suldieres. Count: 81.1% of patient has more than 60 million/mil sperm at spermogram and lower 3.5% were Azoosperm. In this study the pick of age was between 19-21 years. 90% of patients had varicucele in left testis and 3% had varicucele in right testis. The volume of sperm in 94% of patient was upper 1.5 milliliter and only 60% of patient had under 1.5.Conclusions: We understand that the results of study had been equalized with the other studies.

Background: Nosocomial infections are one of the most important causes of mortality and morbidity in hospitals. These infections have the most common frequency in intensive care units. The wide use of the drug caused evident resistance of bacteria to this antibiotic. The aim of the study was to investigate the Frequency and antibiotic resistance profile of bacteria isolated from the Intensive care unit and General ward at a general hospital in Tehran.Material and methods: In this cross-sectional study, we isolated 629 bacterium species from inpatients of Intensive care unit and General ward during one year (2005-2006). Identification was done by standard bacteriologic methods. Bacterium sensitivity to sixteen antibiotics was assessed with disc diffuse method on Muller-Hinton agars.Results: ICU patients showed the increased percent of infections by gram positive bacteria and fungi. But decreased percent of infections by gram negative bacteria compared to general ward (p<0.01). The most common pathogens isolated were Klebsiella (22.4%) in ICU and Escherichia coli (31.6%) in general wards. The highest resistance to antibiotic in ICU, was for ceftazidime (87.9%) and highest susceptibility for vancomaicin (7.7%). The highest resistance to antibiotic in general wards, was for cefotaxim (87.6%) and lowest was for vancomaicin (7.7%). Antibiotic resistance to more antibiotic was significantly high in ICU compared to general ward (p<0.01).Conclusion: These findings provide useful information for future surveillance in association with prevention programs. Subsequently, surveillance should be focused on patients in intensive care unit.

Background: Iron deficiency anemia is the most prevalent blood disease during infancy and childhood and iron deficiency even in the absence anemia could negatively impress the growth and development. Iron deficiency anemia causes the destruction of proximal tubules and extension of peritubular space, especially in the cortex of kidneys. Hypoxia is assumed as the main cause of these changes. According to some studies, treatment with supplemental iron has led to renal function reach it's normal level. We planned our study to to investigate the tubular function in children suffering from iron deficiency anemia in Mofid Children's Hospital.Material and Methods: We performed our descriptive cross sectional study on the children admitted in Mofid Children's Hospital for any reason and the same time suffering from iron deficiency anemia. Via continuous visits and census, 60 children aging between 3-60 month who met inclusion criteria, entered the study and investigated for probable defects in tubular reabsorption of Na,K,Ca, Phos and proteins. Collected data were analyzed by SPSS version 11.Results: 52(87%) patients who entered the study had at least one indicator of tubular dysfunction. While the most common tubulopathy was protein losing (65%), the most uncommon was impaired reabsorption of k+ (p<0.05). Among criterias for iron deficiency anemia, total iron binding capacity(TIBC) was higher in all patients with at least one tubular dysfunction in comparison with patients without such an impairment. The difference between groups was statically significant for defects in reabsorption of Na+, K+ and Phos. ions. Tubular protein losing was more prevalent in younger patients and defects in reabsorption of K+ ion, was more common in patients with lower weight.Conclusions: According to high prevalence rate of tubular dysfunctions among those children suffering from iron deficiency anemia and lower age and weight of these patients; to avoid renal dysfunctions, it is reasonable to start the treatment as soon as possible.

Background: The places in which the anterior teeth appear to touch have been referred to as the Connector Zone (Space).There is the distinction between a connector zone and contact point.Connector zoneis one the interposing factor if smile design which may vary with moving away from midline in anterior teeth, so the variation of this space should be very well noticed in order to reconstruct a good smile. Because of absence of this kind of a research in Iran and also presence of some incomplete article related to this topic, we decided to assess (analyze) the position of connector zone in anterior teeth of both female and male scholars and referred patients with different ages at Tehran Islamic Azad University, school of dentistry in 1384.Materials and Methods: This was a descriptive study in which 320 female and male samples divided in to four 10-year old groups (20-30 year-old, 30-40 year-old, 40-50 year-old, above 50 year- old). All of the interfering variables were omitted. Different stages of this study were clinical examination, completion of informative form, providing two photographs from frontal and lateral  view of anterior teeth using digital camera and analyzing images in P.C. Connector zone rate between maxillary central incisors, between maxillary central and lateral incisors, and also between maxillary lateral incisors canine were finally measured considering 100 percent of the maxillary central incisors length and this results are obtained which presented in tables and charts.Results: This study showed that the rate of C.Z. among maxillary anterior teeth decrease with moving away from midline. It has been also defined that sexuality is not an influencing factor in this issue. Rate of C.Z between maxillary central and lateral incisors and also between maxillary lateral incisors canine will increase with aging while it will not change noticeably between maxillary central incisors with aging.Conclusions: These results may empower dentists a criterion which will help them to reconstruct a proper smile line regarding their patient age.

Background: Third kidney transplant is very uncommon and technically is much difficult. We evaluate technic, results and complications of third Grafts in our center and comparing it with multiple grafts in other centers.Materials and methods: In this cross-sectional descriptive study from 1991-2006 we evaluate 9 cases of third kidney transplant from 2157 transplantations which performed in our center. All patients were treated with intra abdominal approach. Right internal iliac stump and common iliac were preferred for arterial anastomosis and Left common iliac was the most vein used. All ureters were anastomosed with extravesical lich technique.Results: Average age was 44.2 years and male to female ratio was 2/1. In 38 months of follow up two third of grafts with mean creatinine level of 1/3mg% were functioning. Important surgical complications (vascular and urologic) were not observed. we treated two dehiscence of wound without any effect on graft function.Conclusion: In spite of first and second grafts which have standard surgical technics, third transplant often needs numerous individualized and difficult technics and because of infrequency skill is very late finding in a surgeon experience, but surgical result and graft function is comparable with first and second transplant and surgical complication is not more.

Background: "Prerenal" azotemia is the most common cause of acute renal failure that almost caused byhypovolemia and or sepsis. Good management of these, results in good prognosis and prevents of chronic renal failure.Case report: We report a 20 years old man in coma, incontinence and fever that restricted in military concentration camp and was on water and food strike from 4 days. He had prolonged time abuse of methamphetamine and other narcotics as injectable forms.We detected uremic encephalopathy due to prerenal azotemia that controlled by hemodialysis. Azotemia was accrued base on infective endocarditis, that treated by ceftazidim and vancomycin in 4 weeks.Conclusions: Water and electrolytes resourcement, supportive treatment of kidney by dialysis and specific treatment of infections are the "Goal" of management in this patient.