Jundishapur Scientific Medical Journal
Year:2004 | Volume:- | Issue:41|Papers Count:14

Cervical cancer is the second most common cancer in women after the breast cancer. The elevation of individual health and participation in screening program can lead decrease of prevalence of some cancers such as cervical and breast cancers. Through education and increase in knowledge at least one third of cancers are preventable. The purpose of this descriptive study was to determine the level of knowledge, attitude and practice and analysis of demographic factor of subjects studied. The source of this study was self-administered questionnaire which included five items of information about knowledge, attitude, practice, socio-demographic factors and gynecology complication of the subjects. The data collected by self administered questionnaires taken from 400 women who. had the set criteria among subjects visited ten clinics in Zahedan during a three-month period from the 23 September until the 22 December 2002. The analysis of the data collected in this study was made using in feral statistical tests. The results showed that most women had moderate knowledge and practice and were indifferent in attitude. Subjects who were younger than 20 years and older than 40 years had lower scores (P<0.02), were among Baloch women, of lower social classes (P<0.0001), and they had low educational level (P<0.0001). They evidently had lower knowledge, attitude and practice score and only attitude relating to job showed significantly relationship (P<0.0001). Therefore, for successful implementation of screening programs, it is essential that educational programs that aim at elevating the knowledge, attitude and practice should be carried out concurrently.

Inguinal henia is a common disease, which can be repaired with several methods. One of the most important postoperative complications is recurrence, which varies in incidence according to the type of operation. This study was performed prospectively among 60 patients with inguinal hernia in Ahwaz Imam Khomeini Hospital between 1376- 1379. The patients were randomly divided in two groups and hernia was repaired with either tissue or prosthetic method. Follow-up was done for 6-30 months. The mean duration of the follow-up for both groups was approximately 17 months and recurrence occurred only in two patients from the tissue repair group and none of the patients in both groups had wound infection. The results showed that right-sided indirect inguinal hernia was the most common type and mainly occurred in 50 to 80 year old males In conclusion, repair of inguinal hernia with prosthetic material (mesh) is a more appropriate method with low incidence of recurrence, without increased incidence of complications and useful in either primary or recurrent hernia.

One of the most common problems in today"s  developing world is the very high rate of population growth or "explosion of population". Therefore we need a reliable method of contraception which not only should have the least complications for patients but also the most efficacy in producing contraception. Tubal ligation (TL) is one of these methods. In this study late complications and failure rates of two common methods of TL were studied. In this randomized semi-experimental study, 100 women who volunteered for TL were randomly divided into two equal groups. The operation on women in the first group was performed using minilaparotomy technique (M) and for the women in the second group laparoscopic technique (L) was used. Furthermore, the condition of the women was observed closely for a period of one year after the operation. The study showed that L group had more menstrual irregularity, menorrhagia and dysmmenorrhea than M group (p<0.01, p<0.05 and p<0.0001 respectively). There was no difference in psychiatric morbidity in the two groups (4% of patients in both groups). No one regretted TL. Libido increased or was unchanged in 96% and decreased in the others. These percentages were the same for both groups. No severe menstrual irregularity needing hospitalization for laparotomy, D&C or hysterectomy was observed in either of the two groups. The only complication which was higher in M group than L group was problems with incision location (36% versus 18% value (P<0.05). No Failure rate was observed. There was no change in incidence of menometrorrhgia after M operation and even decreasing of menstrual bleeding (8 cases) and regularity of menses (2 cases) were observed. This study demonstrated that TL has no effect on menstrual function, has no effect on psychiatric morbidity and menstrual bleeding dysfunction, but it can slightly increase the incidence of dysmenorrhea, especially when performed by laparoscopy method. High rate of complications in unipolar electrocoagulation TL by laparoscope can be precluded by using bipolar electrocoagulation or clips and bands.

The rate of suicide among adolescents has shown a significant increase in the last years. A suicide phenomenon (especially in adolescents) is an increasing expending problem. Not only suicide can inflict irreparable damages to the individual and his/her relatives, but also it may be considered as a social psychopathology. According to the opinion of a number of experts, it may indicate dissociation in sufferer"s collective and social life. The increasing concern about the rate of suicide in the recent decades and its social, economic and psychological consequences has driven the WHO to include the reduction of this rate as one of its objectives and goals. To this end, this research project aimed at investigating the causes of suicides among adolescents. The target population was all the 11 to 19 year old adolescents who had committed suicide in the city of Ahwaz over a six-month period from Esfand 1379 to end of Mordad 1380. The subjects consisted of 52 cases (23 males and 29 females) who were referred to Golestan Hospital. The results showed that emotional-relational (46%) and 12.6% of cases were due to sexual-physical-psychological factors have acted as the main causes of suicide in this group. In conclusion, emotional-relational problems are the most contributing factors in the suicide attempts in adolescents of Ahwaz City.

Desmopressin is a synthetic analog of antiduretic hormone used for control and treatment of noctomal enurisis in patients with diabetes insipitus. Since 1977, desmopressin was shown to useful in prevention and treatment of bleedings in patients with mild hemophilia and vWD. This non transfusional haemostatic agent when infused interavenously, is expected to increase transiently F VIIIc and vWF, 3-5 times above the basal, levels, within 30-60 min and thereby corrects both aPTT and BT defects. The mode of action is only partially understood. With the aim to survey DDA VP haemostatic effect and to avoid the use of blood products to control or to prevent of bleeding episodes we used desmopressin in 30 Iranian patients with mild hemophilia and vWD (type 1, 2A)Desmopressin (Emosint-Kedrion-Italy) was administered intravenously, in a dose of 0.3 µg/kg body weight, diluted in 50 ml normal saline and infused over 30 min. From all patients, 5-7 ml blood sample was taken before and 30-60 min after DDA VP infusion. For evaluation of coagulation, F VIIIc was measured by a onestage clotting time method, vWF: Ag by Elisa and vWF activity by vWF R. CoF activity, and BT by IVY method. The results showed that clotting assays in 20 patients with mild hemophilia A (F VIII, 5-30%) 30-60 min after DDA VP infusion showed increasing of F VIIIc median 3.7 times above the basal level and aPTT corrected median 13 s, without any important side effects. This treatment in 10 patients with vWD (type 1, 2A) increased F VIIIc median 3.7 and vWF, 3 times above the basal levels, leading to shorting of aPTT 12.9 sand BT, 3.4 min in compare to pre treatment levels. Our results showed that desmopressin in mild hemophilia and vWD (type 1 & 2A) is effective and safe, because it provide a form of autologous replacement therapy and usually permits the avoidance of using clotting factor and with potential of decreasing in the cost of treatment.

Delirium is an under-diagnosed cognitive disorder with poor prognosis. In many articles the reported incidence rate of delirium following cardiac surgery varies from 2 to 57 percent. Recently the rate of delirium after cardiotomy has been reported to be more than 90 percent whereas this rate is approximately 10-15 percent in general surgical wards. This is the first comparative study carried out in Ahwaz Golestan hospital in order to compare the incidence rate of postoperative delirium between patients with open-heart surgery and general surgery. Thirty patients with age range of 40.5-63 years old were selected for. each group. The sampling method was easy sampling. A questionnaire was provided containing of patients" personal data and the type of surgery, history and mental status examination based on DSM IV. Memory and attention was measured based on cognitive screen tests. Patients were examined by psychiatry assistant one day before surgery and two to five days after surgery during evening and early morning hours. In order to compare incidence rate of delirium between two groups we used Fisher Exact Test. Three patients after open-heart surgery and 1 patient after general surgery experienced delirium. Statistical analysis did not indicate significant difference between incidence rate of postoperative delirium between these groups. This rate in open-heart surgery was 10 percent and in general surgery was 3.3 percent that is lower than previous studies. This difference may be due to lower age of patients, lower rate of alcohol and substance use, difference in type of surgery, criteria for diagnostic of delirium and use of advanced cardiac surgery and anesthetizing methods. Moreover, religious believes in our culture that diminishes preoperative anxiety may be another reason of the lower incidence in the rate of delirium

Involuntray weight loss (IWL) is a common complaint and in some cases has serious causes. The possible causes of weight loss are extensive. The aim of this study was to examine the causes of unintentional weight loss. In this research we studied 220 [108 female (49%) and 112 male (51%)] patients with weight loss being the chief complaint, without any previous known disease, over a 41-month period. In 196 cases (89%), the etiology of IWL was found and in remaining 24 cases (12%) the etiology remained unknown. The most common cause for IWL was non-malignant diseases, 190 cases (97%) non-malignant versus 6 cases (3%) malignancy. The GI and psychological disorders constitute more than 63% (140/220) of all causes of IWL. Among GI disorders the gastroesophageal reflex was the most common and should be carefully considered. Therefore, the physician must assure patients and evaluate the causes of involuntary weight loss. Prudently, more and wider epidemiological studies on the clinical course of IWL patients and its effect, on morbidity, mortality and prognosis are recommended.

Takayasu disease is an unusual and chronic inflammatory disorder with unknown etiology, primarily affecting the aorta and its major branches. This disease is quite rare with an incidence rate of 1-2 per million/year and its F IM ratio is 9 to 1. Seizure is a rare presentation in Takayasu disease. Headache, dizziness, stroke and syncope are usually common neurological manifestations. A 19-year-old woman referred to Ahwaz Golestan hospital emergency ward with recurrent generalized tonic-clonic seizures for the first time without any positive points in her past medical history. On examination of her blood pressure in the right arm 200/100 mmHg and left arm with 70/undetermined diastolic was detected. Left radial pulse was absent. The necessary conventional treatment was done and finally complete occlusion of right renal artery and left subclavian artery was shown through aorta angiography. According to above findings there were sufficient criteria as suggested by the American College of Rheumatolgoy (ACR), to announce Takayasu in this patient.

Recent studies have been showed possibly immunological factors involved significantly in recurrent spontaneous abortion. Leukocytes as immunological effector cells form a substantial proportion of stromal cells in human endometrium which change during menstrual cycle and pregnancy. In order to determine whether pregnancy loss is associated with immunologic differences in expression of antigenic CD45RB marker in decidua tissues from women suffering spontaneous abortion and to compare these finding with those of gestational age matched decidua tissues from women undergoing therapeutic abortion, formalin fixed paraffin-embedded sections of therapeutic (30 samples) and spontaneous abortions (30 samples) were labeled with CD45RB monoclonal antibody specific for leukocyte population using Dako Strept avidin-biotin-peroxidase technique. Positive cells were counted in eight microscopic fields at 400 magnification. The Z-test was used to compare the decidual leukocyte populations between normal pregnancy and spontaneous pregnancy loss in the first trimester. The result showed that CD45RB-positive cells were scattered through decidual cells and formed aggregates around glands and vessels. Leukocyte population in spontaneous abortion decreased significantly in comparison with normal pregnancy (p=0.033). In conclusion, reduction of CD45RB-positive cells in endometrium of women with recurrent spontaneous abortion indicate leukocyte. population have a critical role in maintenance of normal human pregnancy.

Considering the vital role of calcium ion (Ca++) in human nutrition and due to geographical variations in human milk composition, it would be of great importance to determine the calcium content of milk in different regions. The aim of this cross-sectional study was to determine Ca++ concentration of mature breast milk in Ahwaz, and to determine if it would be necessary to collect breast milk samples from both breasts. From either breast of 53 healthy lactating mothers, 1.5-3 months after delivery, about 10 ml of foremilk was expressed manually. Milk samples were kept at -20°C until the time of analysis. Breast milk Ca++ concentration was measured using atomic absorption spectrometry. Statistical analyses were carried out by SPSS software using paired t-test and Pearson correlation coefficient. The mean breast milk Ca++ concentration was 235 mg/L. There was no statistically significant correlation between the 2 breasts with respect to Ca++ concentration, but there was a significant correlation between the average of Ca++ concentration of the two breasts combined with that of either breast separately (p<0.01). Our findings suggest that taking a random sample from one breast is sufficient to determine Ca++ concentration of human milk.

The aim of this research was estimation of short-term exposure to formaldehyde (CH20) and comparison with standard of recommended exposure limit in the medicine students at anatomy room in Ahwaz University of Medical Sciences. Th level of exposure to CH2O was measured according to NIOSH Manual of Sampling and Analytical Method number 3500. One hundred air samples were collected during environmental and personal sampling. The amount of absorption of samples was absorption determined by method of chromotropic acid with visible spectrophotometric at 580 nm wavelength. The concentrations of samples were extrapolated from standard diagram. The results showed that, the mean value of environmental concentration of CH2O was 0.414 ppm. (ranged form 0.29 to 0.52) and the mean value of personal breathing zone concentration of CH2O was 0.568 ppm (ranged from 0.43 to 0.67). The amount of short-term exposure to CH2O exceeded that of the REL-ceiling, which equaled to 0.1 ppm recommended by the NIOSH. The exposure was medial compared to classification by NIOSH (0.1-1 ppm). The results obtained from this study showed that, the status of distribution of environmental and personal concentration of CH2O were uniform during Saturday, Monday and Wednesday, and differences were not significant. Furthermore, the amount of personal exposures were significantly increased compared with environmental exposures (P<0.05). The results obtained from this research revealed the requirement for designing, manufacturing, testing and fitting of a portable exhaust local ventilation system in the anatomy room of this university.