Jundishapur Scientific Medical Journal
Year:2010 | Volume:9 | Issue:5 (68)|Papers Count:13

Background and Objective: Evaluation of new scientific journals and books show that there is recently specific attention to physical and Psychological Problems in elders. Scientific studies show that aging as a long period with all problems is accepted as an individual and social fact. So studying, research and helping elders to adjust with problems in aging is serious and important. The aim of this research was evaluating health position in retired Ahvazian residents.Subjects and Methods: Two hundred thirty three Subjects of Ahvazian elders (118 Women and 115 Men) 65 years and older were selected randomly from the list of Iranian Statistic Department in Tehran. For mental health measuring symptom check List 90- Revised (SCL90-R) scales and for satisfactory of retirement, Retirement Descriptive Index (RDI) scale were used. SCL-90-R measures the modalities of somatization, obsessive-compulsive, depression, interpersonal sensitivity, anxiety, aggression, phobia, paranoid and psychotisism. RDI scale has four domains, these domains are: activity, monthly income, health situation and people contact with.Results: This research showed in the domains of satisfaction of retirement, elders were most dissatisfied from monthly income (mean: 17.46±10.91), and health situation (mean: 19.65±12.9). In health modalities elders showed more depression (mean: 28.29±10.89) and somatization (mean: 20.45±7.82).Conclusion: The results of this study, shows that the low level income and undesired health situation are most reasons which make elderly unsatisfied in retirement period. These factors make them depress and they may complain of body situation in next stage.

Background and Objective: Stroke and cognitive impairment after coronary artery bypass grafting (CABG) are associated with cerebral embolization. An important cause of embolism is manipulation of the ascending aorta. There are two distal and proximal anastomosis in CABG that can be done by single cross-clamp or by on cross-clamp and one side-biting clamp on ascending aorta. The later is done for reducing cardiac ischemia. Single clamp technique may be associated with lesser cerebral injury. The Aim of study is survey of surgical Complications of CABG.Subjects and Methods: This study was carried out over 26 months (from oct 2006 until Jan 2009). Patients referred for CABG to a private hospital (n=187) single clamp was used (group I), while patients referred to university hospital (n=187) were operated upon by conventional method of multiple clamps (group II). The incidence of cerebral injury that was clinically patients referred diagnosed in both groups were analyzed.Results: There were one left side hemiplegia and one mortality in group I and one left side hemiplegia and two cases of encephalopathy without any mortality in group II.Conclusion: The results of this study suggest that there is no benefit of single clamp over multiple clamp technique in terms of reduction in the incidence of stroke although there are some advantages of single clamp in causing less cognitive disorders.

Background and Objective: Diabetes mellitus is one of the most important chronic diseases which are substantially increasing in the world especially in developing countries. Nowadays changes in life style, inadequate diabetic habits, sedentary life and obesity are among the most significant causes of type 2 diabetes. Increase in general population knowledge can greatly reduce the expansion of the disease and progression of its complications. The aim of the present study was determine population knowledge of diabetes mellitus in Ahvaz.Subjects and Methods: This was a descriptive cross-sectional study on 400 visitors of Simorgh exhibition of Ahvaz University of Medical Sciences which was held during the 10 days of Fajr in 2009 were the subjects of this study. Data were collected by a questionnaire and analyzed by chi-square test with SPSS.Results: The awareness of diabetes amont Ahvazians was good in 36.8%, at intermediate level in 44.2% and weak in 19% of the subjects of the study. Average age of participants was 31years.Women's knowledge was more than men (P<0.001). Married persons had more knowledge than unmarried (P<0.001). With increasing in education level, knowledge on diabetes also increased. Housewives and official clerks had more knowledge than others. The presence of diabetic patients augmented the knowledge of other members of the family. Friends, acquaintances and relatives were the main source of information and the other sources, in descending order, were magazines and books, radio and TV and physicians.Conclusion: The results of this study suggest that the overall population's knowledge on diabetes is at an intermediate level. We conclude that although the population knowledge on diabetes is in an intermediate level, removing two factors of increasing age and presence of diabetic patients in the family from the study yields in an intensely reduced knowledge and thus it is required to get knowledge on diabetes from lower ages.

Background and Objective: The mainstay of management of severe b-thalassemia remains lifelong blood transfusion. The development of one or more alloantibody against specific red cell minor antigens is a common complication of chronic transfusion therapy. Delayed hemolytic transfusion reactions are due to alloantibodies cause increased blood requirement in transfusion-dependent b-thalassemia patients. This study was performed to detect the frequency and predominant pattern of alloimmunization in the target population.Subjects and Methods: This is a cross-sectional study carried out on 133 transfusion-dependent b-thalassemia patients referring to Shafa hospital-Ahvaz. Antibody screening and identification technique employed was tube method. All panel test phases were done at immunohematology laboratory of Iranian Blood Transfusion Organization.Results: Among the selected patients, 66 were males (49.1%) and 67 were females (50.9%), with a mean age of 17.63 years (SD±7.6). The antibody screening panel was positive in 42 patients (31.57%), of whom 25 patients (59.52%) had alloantibody and 17 patients (40.50%) additionally had autoantibody. The predominant patterns of alloimmunization were anti-Rh (55%) and anti-Kell (33%). Frequency of alloimmunization were significant with increasing duration of transfusion (P=0.01), history of splenectomy (P=0.03) and b-thalassemia intermedia (P=0.02).Conclusion: Alloimmunization was a common complication in our transfusion-dependent b-thalassemia patients. It's recommended that before embarking on transfusion therapy, patients should have extended red cell antigen typing that includes at least Rh and Kell blood grouping, in order to help reduce the likelihood of development of immunological responses later.

Background and Objective: Tinnitus is defined as the perception of sound in the absence of any appropriate external stimulation. About 1-2% of the population is severely disturbed by tinnitus and it may disrupt daily activities and sleep. Several treatments are applied for this disorder and one of these treatments is acupuncture. The aim of this study was to finding scientific evidence for efficacy of acupuncture on this disorder that is resistance to conventional treatment modalities.Subjects and Method: This study is a clinical trial. In this study, 50 patients with resistance tinnitus to conventional treatment who referred to ENT ward of Emam Khomeini university hospital, Ahvaz, were chosen and divided to two groups (each 25 cases). The first group was used as treatment group (with acupuncture) and the other control group. Tinnitus Handicap Inventory questioners were completed for both groups before and after the allocated treatment period. All of the 25 treatment group cases underwent daily treatment for 15 secessions of 30 minutes each. The results analysis with SPSS software.Results: In case and control groups, the males were 56%, 52% and the females were 44%, 48%. The mean period of disorder in case and control groups was 5.8 and 5.6 years respectively. The results of THI were according to assessment quantity and quality. In case group, there had significant difference before and after treatment (P=0.03). Also, the case group after treatment and group control had significant difference (P=0.02).Conclusion: According to this finding, it is thought, the acupuncture is useful for treatment of tinnitus, especially in this condition that there is no proven treatment for it.  More studies are necessary to find the better management methods.

Background and Objective: Epilepsy can cause some problems for epileptic child and adolescences that are negative affect on quality of life in these patients. Relaxation was effective in reducing seizure frequency. Purpose of this study was to investigate the effects of progressive muscular relaxation on quality of life in adolescents with epilepsy.Subjects and Methods: This investigation is a quasi-experimental study. Twenty epileptic people were selected by goal-based sampling. Data were collected in start of research, 4 weeks late and past of intervention by interview, demographic questionnaire and Iranian version of the QOLIE-AD-48 questionnaire. Participants were asked to practice the technique 20 minutes daily at home for 4 weeks.Findings: findings had showed school performance had the highest score in quality of life (89.52) and attitude toward epilepsy had the least score in quality of life mean scores (22.5) of patients. Quality of life mean scores improved from 62.27 to 71.95 after intervention period (P<0.001). All five domains of quality of life scores (epilepsy impact, memory- concentration, health perception, school performance and physical function) (P<0.001) enhanced after relaxation practice period but it was not significant for the mean scores of social support, stigma and attitude toward epilepsy.Conclusion: Findings showed effects of progressive muscular relaxation on improving quality of life of epileptic adolescents.

Background and Objective: Previous studies showed that consanguineous marriage increases the incidence of mortality, congenital malformation and mental retardation in offsprings. One of the most important factors in appearance of disability and genetic diseases is consanguineous marriage in Iran. This study aimed to comparing the prevalence of family marriage in disable and healthy children's parents in Ahvaz city, Iran.Subjects and Methods: one hundred and thirty four disabled and 134 healthy children who were selected randomly in Ahvaz were evaluated in this case-control study and were matched by age and sex. Variables included consanguinity in parents, presence of a disabled person in the family, Mothers illness record and some parent's demographic factors. Data were collected by a questionnaire and analyzed by chi-square test, logistic regression and independent t-test.Results: The study shows that the rate of family marriage in case and control groups was 79.1% and 57.4% respectively. There was a significant relationship between disability and consanguineous marriage, pregnancy age, history of convulsion and cyanosis, maternal diseases in pregnancy, being of a disabled family member and birth spacing from previous child (P<0.05). There was, no significant relationship between ethnicity, mode of delivery, history of jaundice, and birth spacing from next child and disability (P>0.05).Conclusion: Based on these findings consanguinity is the most important factor of genetic disorders and disability among the subjects studied. Therefore appropriate actions should be considered for decreasing the incidence of disability including: promotion of youth and families knowledge relating to risks of consanguineous marriage, available premarital genetic consulting and provision for prenatal screening tests.

Background and Objective: Attention-deficit-hyperactivity disorder (ADHD) in adults is accompanied with different complications such as decreased occupational and educational performance. At present, stimulant drugs are used as the first line treatment in this disorder. However, possible development of side effects and dependence on these drugs are of concern. Therefore, it was decided to evaluate the efficacy of reboxetine in the treatment of adults with attention-deficit-hyperactivity disorder.Subjects and Methods: Forty adult diagnosed with ADHD without any significant psychiatric disorder were participated in a 6-weeks a double blind clinical trial with reboxetine (8 mg/d) in two divided doses. The principle measured outcome was the Conner's ADHD Rating Scale (adult version).Results: Rate of response (decrease of Conner’s rating scale scores) in reboxetine group were significantly greater than control group (p<0.001).Conclusion: Reboxetine may be an effective treatment for the adult with attention-deficit/ hyperactivity disorder.

Background and Objective: The purpose of this study was to determine the effectiveness of stress inoculation training on the Somatization and Anxiety of coronary heart disease patients.Subjects and Methods: Subjects were consisted of 40 patients with coronary heart disease, who were randomly selected from the hospitals Golestan, Mehr, naft and Tapesh Clinic of Ahwaz, through systematic sampling method.These patients were randomly assigned to experimental (N=20) and control (N=20) groups. There were 10 females and 10 males in each group. The experimental group received 8 weekly sessions of stress inoculation training that the control group did not received it. It was hypothesized that training would increase the general health of the training group as compared with the control group. The GHQ-28 was administered to both groups before and after training.Results: The results of analysis of covariance showed that training significantly improved the general health in the experimental group as compared with the control group. Also, compared with the control groups, the experimental group showed significantly lower scores on the somatization Anxiety disorder and insomnia.Conclusion: The result of research showed the stress inoculation training effected on the amount of general health, somatization and Anxiety disorder and insomnia in coronary heart disease and this method can be used with usual medicine care in improvement and rehabilitation in cardiovascular diseases.

Background and Objective: Surgery can cause high levels of anxiety in patients. Preoperative anxiety can increase postoperative pain and need for postoperative analgesia, delay wound healing and increase stay in hospital. Nurses often look for ways to help control anxiety following surgery and disease. Aromatherapy is currently recognized as a comple- mentary therapy and tool holistic nursing care in many countries that may help patients and lower their anxiety. The aim of this study was evaluation the effect of inhalation aroma- therapy on level of anxiety in patient before abdominal and heart surgery.Subjects and Methods: This research is a randomized clinical trial on 72 preoperative patients who admitted to Golestan and Emam Khomeini hospitals in Ahvaz city in 2008. Patients divided in two groups; first group took inhalation aromatherapy with lavender oil and second group took water vapor as inhalation placebo. The level of anxiety evaluated by Spielberger’s State Anxiety questionnaire before and after intervention and vital sign docum- ented. The data were analyzed by t and chi square tests.Results: The results of study showed that mean of anxiety rate before intervention in inhalation aromatherapy group was 51.00±8.94 and after intervention decreased to 38.61±9.79, whiles this mean before placebo group was 50.67±9.69 and after, received to 49.53±9.37. Statical paires t-test reveals no significant difference between mean before intervention in two groups (P=0.88), but after intervention the result showed significant statistic difference between them (p=0.001).Conclusion: The findings imply that inhalation aromatherapy decreased anxiety in preope- rative patients and can use as a complementary therapy.

Chronic kidney disease (CKD) is a worldwide public health problem. Increasing evidence indicates that earlier stages of CKD can be detected through laboratory testing, and that therapeutic interventions implemented early in the course of CKD are effective in slowing or preventing the progression toward end stage renal failure and its associated complications. Each physician should consider how he/she can contribute to an increase in the local screening, identification, and treatment efforts for CKD. Multidisciplinary collaboration between physicians, health care workers, and the government is necessary to halt the progression of CKD. Unfortunately, there is paucity of data concerning epidemiologic characteristics of CKD in Iran, resulting in lost opportunities for prevention. The present article summarizes recent observations about CKD epidemiology, both in Iran and worldwide.

Brown tumor or Osteitis Fibrosa Cystica (OFC) is a rare clinical entity complicating hyperparathyroidism. It may occur in the head and neck, with the mandible being the most frequent site. Primary hyperparathyroidism is usually associated with hypercalcemia. We report a 35 years old female with mandibular brown tumor secondary to primary hyperparathyroidism. In this case in spite of primary hyperparathyroidism and the bony lesion the serum calcium level was within normal limit. This case demonstrates that in osteolytic bony lesions a hyperparathyroidism complication can be expected even with normal serum calcium level. The presence of normocalcemia in hyperparathyroidism should prompt the physician to measurement of ionized calcium and look for vitamin D deficiency, magnesium deficiency, impaired renal function, use of interacting drugs and associated disorders. If there weren’t these factors, normocalcemic primary hyperparathyroidism should be considered.