Jundishapur Scientific Medical Journal
Year:2012 | Volume:11 | Issue:3 (78)|Papers Count:14

Background and Objective: Postmenopausal vaginal bleeding (PMB) is a common and important clinical problem. PMB is caused by endometrial cancer in about 10% of patients. Most reports indicate that endometrial atrophy is the most common cause of PMB. Most of them for more evaluation are admitted for dilatation and curettage (D& C). The purpose of this study is to find in which patients, transvaginal ultrasonography (TVS) can replace with D& C.Subjects and Methods: From April, 2008, through June, 2009, 98 women with PMB underwent TVS and histopathologic evaluation of the endometrium after D& C or after hysterectomy. Normal appearance at transvaginal sonography was defined as a thin (≤5 mm) and diffuse smooth with smoothly marginated and homogeneously echogenic endometrium. However a suspicious appearance was defined as either irregular thickening of the endometrium or an inhomogeneous end oluminal mass or pedunculated endoluminal mass or any endometrial thickness above 5 mm.Results: At histologic examination: of 98 women, 44 (45%) had an atrophic endometrium, 11 (11%) had carcinoma, 10 (10%) had hyperplasia, 28 (29%) had polyps and 5 (5%) were others (ovarian tumor, leiomyosarcoma and multiple or giant leiomyoma) For carcinoma, the sensitivity of TVS was 100 %, specificity was 41.38 %, PPV was 17.4 %, and NPV was 100 %.In addition, the specificity of TVS for atrophic endometrium was 100 %.Conclusion: TVS in patients with PMB is an excellent tool for the determination of whether further investigation with curettage or some form of endometrial biopsy is necessary and sensibly decreases the number of invasive methods. TVS also improves clinical decision- making, and the clinicians diagnostic certainty.

Background and Objective: Cellulitis is an acute infection of cutaneous and subcutaneous tissue. Inaccurate treatment of cellulitis can cause important complications like abscess, myositis, osteomyelitis, bacteremia, septicemia, endocarditis, meningitis, and other complications and can lead to death. The aim of this study was to assess the epidemiology of cellulitis that result in complication among in-patients in infectious diseases ward.Subjects and Methods: The population of the study included all patients admitted with final diagnosis of cellulitis in the infectious ward of Ahvaz Razi hospital during 2001-2003.Regarding variables under study (age, sex, occupation and underlying diseases), the relation between complications caused in relation to each of the complications and these variables were assessed. Data were analyzed by SPSS-15 and using descriptive and analytical statistical methods and chi-squared test with P<0.05 was considered significant.Results: In this study, of totally 230 cases, 150 cases were studied. The results were including: 25 % of total patients encountered with complications, 18.7% of complications were abscess, 3.3% of complications were necrotizing faciiatis, 0.7% of complications were sepsis and 2.7% of complications were osteomyelitis. There was not significant relationship between total cellulitis complications with variables such as: age, sex, job, immunosuppressive disease, consumption immunosuppressive drugs and narcotics injection in patient while there was significant relation between total complications and total incoming trauma, and bite history.Conclusion: The significant relationship between complications of cellutitis and the two variables of trauma and history of animal biting suggest, for better management of these patients, more careful assessment is warranted.

Background and Objective: Anxiety, depression, nausea and vomiting are the most common side-effects of chemotherapy. This study evaluates the effects of massage therapy on these side-effects of chemotherapy.Subjects and Methods: This clinical trial study was carried out on 34 patients with breast cancer. After being assured that the patients suffering from some degree of depression and anxiety and have nausea and vomiting during previous chemotherapy, they were randomly divided into intervention and control groups. Intervention patients had three sessions back massage in addition to the usual care received. Control group only received usual care. After 24 hr each massage session, a questionnaire was completed.Results: These was significant difference between the two groups suffering from anxiety (P=0.0009, P=0.04, P=0.03) and depression (P=0.03, P=0.03, P=0.01) in 2-4 days, but the difference between nausea (P=0.29, P=0.07, P=0.51) and vomiting (P=0.53, P=0.84, P=0.8) was not statistically significant.Conclusion: Massage therapy is cost effective and readily available it is recommended to be used to reduce anxiety and depression. However, it is not effective in reducing nausea and vomiting.

Background & Objective: Dysphagia refers to any disturbance in movement of food bolus from mouth to stomach that is due to neurological motor disorder of swallowing processes. Since, a speech and language pathologist is an active member of the medical team assessing and treating patients with dysphagia, knowledge of basic information about prevalence and etiology of dysphagia seems necessary for planning of rehabilitation programs.Subjects & Methods: In this retrospective descriptive study, 1860 medical profiles of hospitalized patients of educational hospitals in the city of Ahvaz were randomly selected. By the use of NDPCS checklist, data regarding existence or nonexistence of dysphagia, etiology of dysphagia, prevalence of dysphagia in different age and sex, accompanying speech disorders, and prevalence of dysphagia in different wards of the studied hospitals were recorded and entered into SPSS software for analysis.Results: 4.2% of total patients had dysphagia (4% male, 4.5% female). No significant difference was observed between sexes regarding prevalence of dysphagia (P>0.05). Neurologic diseases were the most frequent causes of dysphagia. Males aged between 0-10 years had the highest dysphagia rate. The highest and lowest dysphagia rates were observed in neurology ward and internal medicine ward of the studied hospitals.Conclusion: The finding of this study suggest that speech therapists to pay more attention to age, common etiology and hospital wards with higher dysphagia rate and it is recommended to use early interventions for dysphagia.

Background and Objective: Rheumatoid arthritis patients have identified pain as a distressing symptom that interfere their ability to enjoy life and to take care of themselves. The purpose of the study was to assess the effect of acupressure on pain intensity in rheumatoid arthritis patients.Subjects and Methods: This is a clinical trial study. The data were collected from the clinic of rheumatology of Golestan hospital in Ahvaz, physician’s private surgery and patient's home. Regarding the objectives of the study, 60 patients were randomly divided into two acupressure and control groups. The main outcomes measured were the demographic form and VAS scale that were collected at first and last intervention sessions.Acupressure was a accomplished with direct finger pressure at 1 minute in Hegu, Quchi, Zusanli and Taichong in 12 sessions, control group did not received complementary treatment. The data were analyzed with SPSS version 17 and paired t-test test.Results: There was not a significant difference between the averages of pain intensity in acupressure and control groups at pre- and post-treatment (P=0.813).Conclusion: Despite lack of significant effects of acupuncture on the severity of pain in rheumatoid arthritis patients, further research in the field of acupressure is recommended.

Background and Objective: Patients with neck pain are the second largest group after low back pain attended for physical therapy. Sensorimotor deficits in chronic nonspecific neck pain may alter cervical afferent input. Altered sensory input of the cervical spine structure, mediated via the direct neurophysiologic connections to vestibular and visual system has the potential to disturb postural control.Subjects and Methods: In this case-control study, postural stability was measured by force plate in 24 nonspecific chronic neck pain & 24 matched healthy subjects. Each case performed double limb & single limb standing with t level of difficulty (rigid-foam surface). Measured parameter were mean velocity, standard deviation velocity in the media-lateral and anterior posterior direction. Data were analyzed by 2-way repeated measurement ANOVA.Results: Finding shows that there was a significant increase in standard deviations for velocity in the anterior-posterior and media-lateral direction in single limb stance of subjects with non-specific chronic nonspecific neck pain. In double limb stance, statistically significant differences were found in both allocated groups.Conclusion: Dissimilarity in postural performance chronic nonspecific neck patient is a reflection of different degrees of disturbances of the proprioceptive input to central nervous system and/or of the central processing of such input. Therefore, treatment methods for address neck position and balance training are suggested.

Background & Objective: Hype ricin is a naphtodianthrone with multiple pharmacologic actions. Hypericum triquetrifolium Turra grows in different part of Iran. The aim of the present study was to isolate and determine the quantity of hypericins in different parts (leaf, flower and stem) of this plant grown in Khozestan province.Matrials & Methods: Different parts of Hypericum triquetrifolium Turra (leaf, flower and stem) were collected and extracted with methanol 50% using soxhlet apparatus. Hypericin was determined using UV/Visible spectrophotometer at 590 nm.Results: The percents of hypericin in leaves, flowers and stems were 310, 210 and 150 mg/100 g, respectively.Conclusion: Leaves and flowers of Hypericum triquetrifolium Turra have considerable amounts of hypericin.

Background and Objective: Thalassemia major has severe clinical symptoms with craniofacial defects that produce esthetic problems in patients. Orthodontic treatment and surgical reconstruction in these patients have had good esthetic results and therefore satisfying pschycosocial effects. Researches have shown an increase in the level of life quality corresponding to health improvement in thalassemic patients. More knowledge and information is necessary for better treatment of skeletal problems in thalassemia.Subjects and Methods: This descriptive and analytic study was performed on 48-beta thalassemia major patient and 48 normal samples. They were divided into two groups (24 persons) based on their genders. Including criteria for samples were: being more than 15 years old, not being affected by special disorders, not having orthodontic and orthopedic treatment, having Cl I profile, normal facial height, Cl I molar relationship, normal overbite and over jet and the presence of all permanent teeth (except third molar). Cephalometric analysis was used for evaluation of cephalograms. The results were analyzed using descriptive statistical and paired sample T-test (P<0.005).Results: SNA angle did no significant increase, but SNB and ANB angles significantly decreased (P<0.005).The angle between SN-Occlusal plans, Frankfort-y-axis plans and basal plans showed increase, but the angle between Frankfort - facial plans (P<0.005) and the distance between pog-NB plan showed decrease (P<0.005).Conclusion: Beta thalassemia major induces Cl II malocclusion and long face growth pattern due to decrease in mandibular growth and decrease in posterior facial height.

Background and Objective: As the economic and health status are improving, elderly population are increasing But, it is clear that increased longevity is notper se is sign of development, quality of life is more important. Quality of life of elderly people is influenced by several factors, one of the most important is social support.Previous researches showed that along with increase in social support, elderly people's quality of life is improved. The aim of this research is finding the relationship between social support and quality of life of the ledelry in the city Kerman, Iran.Subjects and Methods: This survey was performed among 383 elderly men and women living in the city of Kerman. The research tool was a questionnaire with interview, SF36 questionnaire was used for scaling quality of life and a researcher made questionnaire for measuring social support.Results: The most important supporters were, in the first degree, was wife/husband followed by then son and, in third degree, daughter. Mean score of physical quality of life was more than average mental health score. The results showed that emotional support, financial services, advisory and information, and age are all the components of quality of life.Conclusion: According to these findings, increase in the types of social support, especially emotional support, can be of a great help for improvement in the quality of life for seniors. Of course, elderly people need economic and other supportive services in addition to emotional support.

Background and Objective: Intensive anaerobic exercise is a risk factor for children with sickle cell anemia. However, it remains unclear whether anaerobic or aerobic exercises have any effect on subjects with sickle cell trait. This study conducted to determine of the effect of aerobic exercise on O2 saturation in children with sickle cell trait.Subjects and Methods: Eighty-two healthy and trait children (age 6-18) were allocated randomly in two groups: case (41) and control (41) in this study. Anthropometrics profile and hemoglobin concentration were measured. HbS hemoglobin recognized with HPLC. All children performed a cycle ergometer 2-min exercise and 3-min rest. Before and after exercise, O2 saturation was assessed with pulseoximetry.Results: There was no significant difference between two groups for O2 saturation before and after exercise (P>0.05). This parameter remained normal in children with sickle cell trait.Conclusion: It seems aerobic exercise is safe for children with sickle cell trait.

Background and Objective: Morphine induces adverse effect in many organs. It has been known that moderate exercise reduces oxidative stress. The present study was undertaken to evaluate the effect of exercise on morphine-produced toxicity in rat liver and kidney.Subjects and Methods: Adult male rats were randomly divided in 4 groups including: (1) morphine-treated, (2) morphine treated+exercise, (3) vehicle (normal saine) treated, (4) vehicle treated+exercise. Animals in groups of 1 and 2 received morphine (ip) two times per day for 5 consecutive days.1st day 5mg/kg, 2nd day10 mg/kg, 3rd day 20mg/kg, 4th day 40mg/kg and 5th 50mg/kg. Rats in groups of 3 and 4 received vehicle only. The animals in groups of 2 and 4 were participated in the treadmill exercise sessions (1 h at speed 17m/min) for 10 consecutive days.24 h later, the animals were killed with overdose of sodium pentobarbital. Blood was collected for determination of ALT, AST, ALP, BUN and creatinine. Liver and kidney tissues were removed, fixed and processed for light microscopy. Ten animals were used for each group.Results: Biochemical and histopathological observations indicated that morphine produced injury in the liver and the kidney. Exercise reduced morphine -induced toxicity (P<0.05).Conclusion: Morphine- induced toxicity in rat liver and kidney.Execise protected liver and kidney against morphine-induced toxicity. Blocking of oxidative damage by exercise may be a useful strategy for preventing morphine adverse effects.

Pneumatosis intestinal is isusuallya is a benign condition which may affect any segment of gastrointestinal tract from stomach to rectum.It is also called pneumatosis cystoides intestinal is (PCI). It is best classified into (A) a primary form and (B) a secondary form. Air cysts are found mostly in sub serosa of large bowel. The aim of this study is to present 72-year–old heavy smoker man that referred to emergency department with abdominal pain, nausea, vomiting and decreased appetite for a period of three days duration. With impression of peritonitis due to hallow viscus perforation, as result the patient underwent laparotomy. Abdomen was completely cleaned without any puss or fluid. There were multiple gas containing cysts over the antimesentric colonic wall of the transverse and sigmoid colon. We terminated the operation without any intervention. The patient became symptom free post operatively and discharged from hospital with good condition.