Jundishapur Scientific Medical Journal
Year:2008 | Volume:7 | Issue:2 (57)|Papers Count:21

Objective: Acute bronchiolitis is a common disease of the lower respiratory tract in infants, resulting from inflammatory obstruction of small airways. The treatment of infants with bronchiolitis is largely supportive. The role of bronchodilators is controversial. The aim of this study was to compare the efficacy of nebulized epinephrine and salbutamol in the treatment of patients admitted in emergency department with the diagnosis of bronchiolitis.Subjects and Methods: Fifty-two infants between 2 and 12 months with clinical diagnosis of bronchiolitis were randomized in to receive either 0.5mg/kg, maximum 2.5mg, of nebulized 1 in 1000 epinephrine, (n=25) or 0.15mg/kg of nebulized salbutamol (n=25). Pulse rate, respiratory rate and O2 saturation with pulse oximetry were recorded before, 30, 60, 90 and 120 minutes after treatment.Results: Both nebulized epinephrine and salbutamol caused a significant improvement in the mean clinical score and oxygenation. Tachycardia was found to occur more significantly in the epinephrine group and relapse was found more frequent in the salbutamol group. Infants aged less than 6 months showed a better response to nebulized epinephrine. While infants aged more than 6 months responded to salbutamol better than to epinephrine.Conclusion: Result of this study showed that both nebulized epinephrine and salbutamol are effective in the treatment of patients with acute bronchiolitis. But among infants under 6 months age, epinephrine is more effective than salbutamol.

Objective: Exposure to excessive noise can cause physiological variations in auditory system. These changes may manifest as hearing loss (HL), tinnitus and even vertigo. The aim of this investigation was to compare the degree of hearing impairments among workers in Ahvaz Steel Factory with those exposed to artillery shell explosions during the imposed war.Subjects and Methods: In this analytical study, 400 adults with hearing impaired, aged 20-40 years, were studies and divided two groups: acoustic trauma (AT) and noise-induced hearing loss (NIHL). After otorhinolaryngology inspections, otoscopy, pure tone audiometry, speech audiometry and tympanometry evaluations were performed for all participants. Data analysis was performed by SPSS software and 0.05 values was regard as a significant level.Results: Hearing impairment in NIHL and AT groups was symmetrical in 91 % and 68 % of clients; respectively. The severity of hearing loss in AT group was significantly higher than NIHL group (P<0.05). The resultant hearing problem in NIHL subjects was seen predominantly in 2000-8000 Hz region. While in AT subjects, it was located in 3000-6000 region. We found a significant correlation between the degree of hearing loss and sound intensity level (P<0.05, r=0.085). A large number of subjects in AT group had tympanic membrane perforation and ossicular chain disruption.Conclusion: Exposure to high intensity sounds, even during a brief period, may cause an irreversible damage in auditory system. These damages are more intense when subject expose to impulse noise than when he experiences a steady noise, such as in workplace noise.

Objective: Nasal packing is a common procedure that is used for control of nasal bleeding. On the other hand, nasal obstruction can predispose to abnormal breathing patterns during sleep which often results in hypoxemia. One of the serious complications of nasal packing is arterial O2 de-saturation which is a major risk factor in elderly patients with cardiopulmonary disorders. The aim of the present study was to investigate the effect of postoperatively applied nasal packing on arterial oxygen saturation during sleep among patients requiring nasal package for various indications.Subjects and Method: This study included 68 patients (49 male, 19 female; mean age 29 years, range 19 to 74 years) who required nasal packs for various indications. O2 saturation levels was measured before insertion of nasal packing and postoperatively on the first night after surgery using Pulse oxymetry and the finding were compared statistically.Results: No significant differences were found between before and after nasal packing levels in 59 patients but in 9 patients, with previous underlying cardiopulmonaty disorder, O2 saturation level was significantly decreased after nasal packing.Conclusion: Nasal packing can cause significant reduction of O2 saturation in elderly patients especially in those with cardiopulmonary .disorders. It seems nasal packing has no significantly effect on arterial O2 saturation levels in young healthy patients.

Objective: The aims of the study were to evaluate differences in dietary, oral hygiene habits and social class among children with Type I diabetes mellitus (DM), and non-diabetic children and to investigate the relationship between selected caries risk factors and DMF status among these groups. This study was under taken in Ahvaz, Iran.Subjects and Methods: Thirty one children with type I DM with a mean age of 11±2.34 years and 31 age- and sex-matched non-diabetic controls were included in the study. Metabolic control of diabetes was categorized into well, moderate and poorly controlled groups based on glycosylated hemoglobin (HbA1c).  The data collection was based on physical examination and a completed questionnaire which included information on dietary and oral hygiene habits, social class and DMF. The data were statistically analyzed using McNemara and student t-tests and level of significant was considered with P<0/05.Results: Results showed that the diabetic children had less frequent cariogenic snacking intake than their controls. The mean number nutrition index was 7.65±3.27for diabetic and 11.9±2.03 in the controls. There was no significant difference DMF between diabetic and controls (3.71±2.48 for diabetics and 4.35±2.74 in the controls). There were no difference according to the frequency of tooth brushing and use of mouth washes, but significantly more diabetics reported that they never used dental floss than non-diabetics.Conclusion: Frequent consumption of cariogenic snacks can influence caries development in children. Amongst the diabetics, the difference in caries prevalence can be explained by combination of biological and behavioral factors rather than single dietary or oral hygiene elements.

Objective: Children, especially in developing countries, are a vulnerable group. Therefore attention to hygienic issues related to this group is crucially importance. One parameter that can be used to assess the health status of children is the anthropometric pattern of growth. However, since no standard anthropometric pattern is available in our area and normally NCHS is used as a standard curve for assessment of growth, this standard may not directly related to our children in this area.  In the presented study we aim to determine the anthropometric curves of infant under two years old in Ahvaz city.Subjects and Methods: This cross sectional study was carried out in year 1382 (2003). The data were collected from five health centers of Ahvaz city (Central, Northern, Southern, Eastern and Western). Six hundred health files of children having the inclusion criteria, born in 1378, excluding twines, premature births and LBW, were randomly selected. The data analyzed using SPSS software.Results: There was a significant difference in mean weight between boys and girls (P<0.001), with mean weight boys, from birth until two years of age, was greater than in girls. The average height was also significantly higher (P<0.001) in boys relative to girls for all age groups. Comparing percentile weight of boys with that of NCHS in the age range of 0 to 22 months, the standard the difference was significant (P<0.001). Comparing the percentile mean height of girl with those of NCHS, except for 12 month and 18 month, was significantly different (P<0.001). Comparing distribution of weight amplitude in accordance to NCHS standard for two genders and in the age range of 0 to 22 months (expect at birth birth), the difference was significant (P<0.001). Comparing distribution of height amplitude in accordance to NCHS standard for Ahvazian boys and girls, in the age range of 0 to 22 months (expect at birth and at 22 months of age) the difference was meaningful (P<0.001).Conclusion: The results of the study underline the necessity of a fundamental solution for acquiring local growth curves which are based on genetic and regional patterns in order to examine the situation of  infant  more precise.

Objective: With progress of technology, the necessity for use electromagnetic waves in various instrumentations in human societies is becoming increasingly wide spread. On the other hand, the effect of electromagnetic fields on living organisms is one of the problems of advanced societies. The aim of this study was to assess the effects of electromagnetic field on spermatogenesis and the role of epinephrine as a protective agent in rats.Materials and Methods: for this purpose, a machine was designed which produced an electromagnetic wave of 120 Gausses (12 mT) intensities. Wister rat was chosen as a laboratorial animal model. The rats were divided into five groups (n=25 each). The first group was used for determination of LD50 of epinephrine. The second received the selected epinephrine sub-lethal dose from previous experiment. The third group received saline (control). The fourth group was exposed to electromagnetic wave and received epinephrine. The fifth group was exposed to electromagnetic wave and received normal saline. After dissecting out the testis histo-pathological assessment of the testis were made which entailed evaluation of the number of spermatogonia cells, primary spermotocytes, spermatozoids, interstitial cells and sertoli cells.Results: The results showed a significant reduction (P<0.05) in the number of spermotogonia cells, spermatid and sperm and also significant increase (P<0.05) in number of primary spermatocyte in the group that was exposed to electromagnetic field in comparison with control group. Administration of epinephrine protected the testis from the changes that followed exposure to electromagnetic field and this group did not show these changes in comparison with control group.Conclusion: It seems that electromagnetic field, by promoting free radical production, can cause damage to existing cells in epithelium germinal layer of testis and epinephrine can have a protective effect on the electromagnetic wave possibly by constriction of blood vessels. This hypothesis needs to be assessed in further studies.

Objective: This research has been conducted to detect and measured brain motor cortex activity of 25 normal volunteers during wrist flexion–extension task using optimized Gradient Echo–Planar Imaging (GR– EPI) technique by measuring blood oxygen level dependent changes in MR signal.Subjects and Methods: Scanning was performed on a 1.5 T General Electric MR Scanner (Signa Model) at Naft Grand Hospital. An optimized gradient echo T2*- weighted echo–planar sequence was used with the following parameters FOV=24 cm, NEX=1, TR=2000ms, TE=55 ms, Flip Angle=90o, Matrix Size=128 * 128 and Thickness=5 mm.One hundred and twenty axial images were acquired serially using a block design during rest and wrist flexion–extension task from the motor cortex area of the wrist around Sulcus of Rolando. Acquired images reformatted from DICOM Dicom to Analyze using MRIcro and underwent complex image processing and analysis using SPM2 and MATLAB (Ver. 7).Results: The results showed a significant increase (P£0.05) in S signal intensity of brain motor cortex during the task in comparison with the rest state. Activated areas in brain cortex were shown as clusters of 153 to 185 pixels in size (165.12±9.93).Conclusion: The findings of this study may be used to evaluate the changes of brain cortex activity in various diseases and also to assess the respond to treatment procedures.

Objective: Polymerization shrinkage still is a composite disadvantage. In composite inlays because that indirect restoration fill the most of the cavity, so little composite remains which releases shrinkage. In addition, the shrinkage of composite material depends on their composition and viscosity. The aim of this study was to evaluate micro-leakage in direct composite inlays which cemented with low and high viscosity cement.Materials and Methods: Fifty mesially boxes (2 x 3 x3 mm) with 6o diversion prepared with Surveyor appliance. Composite inlays were prepared and were post-cured in 100oC water for 7 minutes to complete their polymerization. Surface preparation was accomplished with 37% phosphoric acid on both inlays and dental surfaces and Exite bonding and Silane coupling agent were used. Teeth were divided randomly into 2 groups: 1- cemented with high viscosity cement (F2-Dual), and 2- cemented with low viscosity cement (variolink II). Both were prepared manually. All the restorations were polished, thermocycled and dye-penetrated by incubation 24 h in 0.2% Fuchsin. Finally the teeth were sectioned buccolingually and evaluated by stereo-microscope (40x). The data were analyzed with Mann-Whitney test.Results: Only 2 inlays did not show any micro-leakage. Microleakage mean value for high viscosity cement group was 20.60 and for low viscosity cement group was 26.95 (P<0.05).Conclusion: According to this study high viscosity cement has less microleakage than law viscosity cement. Although using low viscosity cement is easier because of better flow property, the quality of high viscosity cement is better.

Objective: The Metabolic Triad (TM) is known as a predisposing factor for cardiovascular events. It seems that hypertryglyceridemia and high waist circumference can predict metabolic triad. In this study the relationship between hypertriglycemic waists with other cardiovascular disease (CVD) risk factors in women in the central areas of Iran was assessed.Methods & Materials: Data prepare from phase I of Isfahan Healthy Hearth Project through a descriptive cross-sectional study. Random-cluster sampling method was used. Blood samples, lipid profile and blood sugar of samples were determined. Waist circumference, height, weight and blood pressure of participants were measured and their body mass index was calculated. Participants were allocated into 4 groups based on the triglyceride and waist circumference: TgHWH group (TG³165 mg/dl, waist circumference³88 cm), TgHWL group (TG³165 mg/dl, waist circumference<88 cm), TgLWL group (TG<165 mg/dl, waist circumference<88 cm) and TgLWH group (TG<165 mg/dl, waist circumference>88 cm). Variance test was used to compare the variables in a group. ANOVA test and X2 test were used to study the prevalence of risk factors of groups. Post hoc Tukey test was used for testing different between groups.Results: A total of 6279 women were included in this study. After deleting the effect of age, results showed that in TgHWH group the levels of cholesterol, LDL, triglyceride, blood pressure, body mass index and blood sugar were higher and HDL was lower than other groups. Furthermore, the prevalence of risk factors in this group was significantly higher than groups. On the other hand, the prevalence of risk factors was lower in TgLWH group than in other groups.Conclusion: TG and waist circumference can be used as the predictor for risk factors in large population in which the measurement of all risk factors is difficult. Furthermore hypertryglyceridemia is more important risk factor than high waist because the CVD risk factors are moderately low in TGLWH group.

Objective: Cystic fibrosis (CF) is an inheritance disease with autosomal recessive pattern that affects many organs. The disease is caused by disruption of transmembrane chlorine channel. Our aim in this study was to parentally diagnose the presence of cystic fibrosis using molecular method in a family with carrier parents and a previously affected brother.Subjects and Methods: DNA from blood and amnion fluid was extracted by routine methods. Restriction Fragment Length Polymorphism (RFLP) was performed to detect the most common mutation in CF gene.Results: Molecular analysis revealed that both parents were heterozygous for D508F and the previous affected child was homozygous for the mutation. However, the fetus was heterozygous and therefore was not affected.Conclusion: Because the parents were not relatives and carried the same mutation, it seems that D508F mutation has a high frequency among Khuzestan population. Screening for mutations in CF gene in Khuzestan population is recommended.

Objective: Diuretics, cardiac glycosides, b blockers, angiotensin E inhibitors and NSAIDs can produce anincrease in serum potassium in cardio-vascular patients. On the other hand, excessive rise of potassium concentration in extra cellular fluids (such as vitreous humor) can predispose to cardiac arrest. For this reason, the measurement of potassium concentration in the extra cellular fluids, such as vitreous humor, because it is anatomically isolated and deteriorates more slowly than other body fluids, to diagnosis metabolic disorders, electrolytes disorders, sudden death, infarction and investigation of crime in forensic medicine is necessary.Subjects and Methods: The present investigation was performed on 88 cadavers (44 male, 44 female) brought for autopsy in forensic medicine of Khozestan. The time of death was reported by relatives or recorded responsible coroners. From each eye a-2 ml sample of vitreous humor was aspirated from the outer canthus. Samples were frozen at -20oC until needed. The samples were liquefied at room temperature and each sample was centrifuged at 3000 rpm for 5 minutes and the supernatant fluid was used or determination of potassium concentration by flame photometric method and values were expressed in mEq/L.Results: The results showed no significant differences in potassium concentration of the vitreous humor of both right and left eyes. Furthermore, no gender differences in the relation vitreous humor potassium concentrations were observed.Conclusion: Potassium baseline concentration of vitreous humor in right and left eyes of dead men and women in Khuzestan follows the following mathematical relationship Y=1.03x + 3.94 , r =1.

Objective: Septal hematoma is one of the most sever and early complications of nasal trauma that lead to septal cartilage necrosis. A nasal septal abscess usually results from an infected hematoma of the septum. While the necrosis of septal cartilage can lead to nasal deformity and sever impairment of nasal patency. The purpose of this study was to evaluate the clinical characteristics, causes and treatments undertaken for patients suffering from hematoma and abscess of the nasal septum.Subjects and Methods: In this cross-sectional study we preformed a retrospective evaluation seventy–four (74) patients who were admitted for treatment of hematoma and abscess of the nasal septum during years 2000 to 2007 at Ahvaz Jundishapur University, Imam Khomeini Hospital. Clinically important diagnostic features, etiology, delay of referral, bacteriological results and type of treatment undertaken as well as age and sex of all the patients were recorded.Results: The mean age of the patients was 9 years (range 11 months to 53 years). All of 74 (55 males and 19 females) patients underwent surgical treatment, 67 of whom had a history of nasal trauma (91%). Hematoma was present in 53 patients (72%) and septal abscess was observed in 21 cases (28%). Nasal obstruction was the most common symptom which was found in all the patients. Pain, rhinorhea and fever occurred in a few cases. The average delay of treatment was 3.5 days for patients with hematoma and 8 days for patients with abscesses. All these lesions were incised under general anesthesia and treated with drainage and nasal packing. The commonest pathogenic organism isolated from the pus of nasal septal abscess was Staphylococcus aureus.Conclusion: The diagnosis of hematoma and abscess of the nasal septum must be considered in all patients who have acute onset of nasal obstruction and history of recent nasal trauma to minimize the risk of nasal deformity and prevent the development of septic complications. Early diagnosis and immediate therapy is mandatory to avoid cosmetic nasal deformity or intracranial infection.

Objective: Radiotherapy is one of the methods used in cancer treatment. In this method tumor cells are exposed to ionizing radiation to kill these cells. More of tumor cells are killed if exposed more radiation within the region of tumor. However, the main purpose of radiotherapy is exposing enough doses to tumor mass yet protecting the normal tissues around it. In this study, we investigate the effect of temperature on the absorbed radiation dose.Materials and Methods: In these experiments a 30 ×30 × 30 cm water phantom, Farmer ionization chamber and related electrometer were used to measure the effects of exposing g_radiation of Co-60. The field size was varied for (5×5 cm2 to 20×20 cm2) with depths (5 to 9 cm) and the range of temperatures (30 to 50oC). The curves for variation of absorbed dose at different depth at different temperatures were drawn and a temperature enhancement ratio (TER) was introduced. Results: Our results showed that TER increases for all field sizes and depths with increase in temperature. A pronounced effect was observed at temperatures higher than 42oC.Conclusion: These findings suggest that the hyperthermia (above 42oC), caused a sudden variation of the structure of water and increased the absorption of radiation dose.

Objective: Acute inflammatory demyelinating polyradiculoneuropathy is an immune system-mediated and acquired polyneuropathy. It usually presents with weakness which progresses during the first weeks of disease to produce a flaccid paralysis. Electrophysiological findings play an important part in the diagnosis and prognosis of the disease. For a  clinician it is important to correlate the clinical manifestation and laboratory findings of the patients with the electrophysiological data, especially when the patients with acquired neuropathies are more treatable than patients suffered from hereditary neuropathies. Because the acquired neuropathies usually have an acute course, based on the time from the onset and the type of peripheral nerve involvement, the electrophysiological changes could be different. Therefore it is essential to find the electrophysiological changes following the weakness caused by acute inflammatory demyelization polyradiculoneuropathy in order to diagnose and evaluate the undergoing pathogenesis.Subjects and Methods:: This study was undertaken from 2004 to 2007 on thirty patients with the clinical impression of acute inflammatory demyelinating polyradiculoneuropathy referred to pediatric emergency room and ward of Ahvaz Golestan hospital evaluated by measuring their nerve conduction velocities and limb electromyography at room temperature. Nerve conduction studies were done by measuring nerve conduction velocities of deep peroneal and posterior tibial nerves bilaterally; recording sural nerves action potentials, determination of F wave latencies of posterior tibial and deep peroneal nerves bilaterally. In addition, compound motor action potentials of tibial and peroneal nerves were obtained from the extensor digitorum brevis and abductor hallucis longus muscles. Needle electromyography examinations of the lower and upper extremities were done at the time of nerve conduction studies at the room temperature.Results: Conduction disturbances were the most detectable electrophysiological finding among the studied group. Between thirteen to twenty percent of patients showed F-latency abnormalities. Sural nerve action potential amplitudes were within normal values. The durations and amplitudes of compound muscle action potentials were impaired. Decreased motor unit interferences were the most obtainable electromyographic abnormalities among the patients.Conclusion: Conduction disturbances are the most common electrophysiological abnormality among the studied group. The information obtained from this study suggests that nerve conduction velocities and limb electromyography assessment can be used to confirm the diagnosis of acute inflammatory demyelinating polyradiculoneuropathy, classify the subtypes of the disease and to predict the prognosis.

Objectives: The purpose of this study was to prepare an easily applicable dressing bandage of aqueous based tragacanth mucilage and compare it with vaseline oily-based gauze.Materials and Methods: Two types of 6% tragacanth mucilage, with or without 5% sodium chloride, were made.  For selection an appropriate pad with a desired quality of saturated tragacanth mucilage, cotton fibers, synthetics and gauze bandages, under aseptic conditions of laminar air flow, with the same weight and ratio of (1:4) as that of vaseline gauze, were prepared. In this study four animal groups (n=5) were selected. The first group left without treatment, second group vaseline gauze treated (positive control group), the third and fourth groups (treatment groups) treated with saturated bandages of 6% tragacanth, with and without sodium chloride.Results: Result showed that the purchased gum was confirmed by references requirements from the viewpoint of appearance, chemical test, absence of Karaya gum and moisture amount. Examination of provided bandages showed that cotton fibers had least changes and most stability from the viewpoint of weight changes, apparent and organoleptic characteristics. The results of microbial test, confirmed the applied microbial preservatives, sterilized condition and performance accuracy of sterilization. The period of complete wound closure in treatment groups with saturated bandages of 6% tragacanth with and without salt were 12 and 13 days, respectively. Statistical comparison of these results with untreated and vaseline gauze treated groups (which lasted 24 and 22 days respectively) were sifnificantly different (P<0.05). The presence or absence of salt did not have any significant effect on the pH, weight changes, appearance, organoleptic and therapeutic properties of prepared bandages of two mucilage products (P>0.05).Conclusions: In comparison with chemical products, tragacanath dressing is a natural and is a safe herbal product. Further clinical evaluations are needed to be performed on human burns.

Bouveret syndrome is especially a rare presentation of biliary ileus.  Gall stones pass to the antrum and prepyloric area through a fistula between gallbladder and stomach and causes gastric outlet obstruction syndrome. Lion Bouveret was the first to describe the syndrome in 1883. This syndrome usually presents in old age, especially female patients, with typical signs and symptoms of gastric outlet obstruction but several presentations with many different symptoms and signs are reported. Diagnosis of the 300 worldwide reported cases of this syndrome were made following endoscopy, CT scan or ultrasonography examination. In spite of development of various non-invasive methods of intervention, surgery is still mainstay of treatment.In this case report, we describe a unique presentation of Buoveret syndrome in which penetration of gall stone into the muscular layer of stomach antrum resulted in sign and symptoms of gastric outlet obstruction.

Sickle cell Patients with either homozygous or heterozygous forms of bo-sickle cell thalassemia are at risk of developing cardiac problems, including the occurrence of sudden unexpected death. Sudden death can arise from significant morphological abnormalities in the cardiac conduction system. However, myocardial infarction is a rare occurrence in young adults with sickle cell disease and may be attributable, in most cases, to acute micro-vascular occlusion of small vessels.In this report, we present an Abadanian, 22 year-old young adult man every Arab ethnicity, who's disease started six years ago with bone pains, and was under six-monthly blood transfusion for control of anemia. Recently he was admitted for bone and chest pain. Perfusion thaliam-scan suggested a myocardial ischemia for which he was treated with hydroxylurea.In view of the fact that the hallmark of sickle cell disease is micro-vascular occlusion, treatment with hydroxyurea not only improved bone and chest pain but also, in this case, caused the disappearance of his myocardial ischemia, raising in Hb-F level and reduced the rate of blood transfusion.

Hereditary pancreatitis (HP)1 is a rare autosomal dominant disorder with recurrent attacks of acute pancreatitis and frequent progression to chronic pancreatitis. Recently, mutations in the human cationic trypsinogen (TG-I) have been associated with HP.Three potential markers for inherited pancreatitis have been identified: (PRSS1, SPINK1, TATI).The disease is characterized by recurrent episodes of pancreatitis and frequent presence of calcified stones and an increased cumulative risk of pancreatic cancer in elderly patients with HP.The diagnosis of hereditary pancreatitis is based upon radiographic testing in the appropriate clinical setting.This study is a presentation of four cases of hereditary pancreatitis from one family.Conservative treatment is advised in acute phase of pancreatitis. Prescribing of antioxidants (such as vitamin C and E), low fat diet and endoscopic sphinctrotomy (ES) and surgery may be useful as therapeutics or preventive measures.