Avicenna Journal of Clinical Medicine
Year:2015 | Volume:22 | Issue:3 (SN 77) |Papers Count:15

Introduction & Objective: The most persistent rhythm in the treatment of cardiac arrest is asystole. In this situation, the survival is rare. The choice is epinephrine, and vasopressin is as an alternative drug. The study purpose is to compare the effects of vasopressin and epinephrine on the outcome of asystole rhythm.Materials & Methods: This clinical trial was performed on 210 patients with asystole rhythm. 105 patients received epinephrine (group1) and 105 patients' vasopressin (group 2) as the first drug. American heart association guideline (2010) was performed on both groups. Then data collection (age, sex, return of spontaneous circulation, survival of first hour, first day and first month, heart rate after 10 minutes resuscitation and survival to discharge) were evaluated. These data were analyzed by SPSS 18 software.Results: There were no significant difference in sex, age, return of spontaneous circulation, survival of first hour, first day and first month after resuscitation between the two groups. But there was a significant difference in post resuscitation heart rate after 10 minutes in group 2 compared to group 1, which was lower in group 2.Conclusion: As tachycardia due to receiving vasopressin is less than that of epinephrine, it may be more effective on survival in some conditions such as its combination with other drugs, administration of multiple doses of vasopressin or acidosis. Although, further studies are needed.

Introduction & Objective: Chronic tonsillitis with caseum has been proven to be the cause of halitosis. The objective of this study was to evaluate the efficacy and safety of temperaturecontrolled radiofrequency tonsil ablation in the treatment of halitosis caused by chronic tonsillitis with caseum.Materials & Methods: In this clinical trial study 28 adult patients with halitosis due to chronic tonsillitis with caseum were treated by temperature-controlled radiofrequency tonsil ablation and efficacy and complications of procedure were recorded and the data were analyzed by Spss software and paired t-test.Results: The difference between the amount of halitosis was statistically significant before and after the procedure (P <0.001). Patients’ pain were mild to moderate .Mild bleeding occurred in 21% of patients and 79% had no bleeding. In average 3.14 days after the procedure patients tolerated regular diet and after 1.96 days they could do their daily routines.Conclusion: Temperature-controlled radiofrequency tonsil ablation is a safe and effective method for treatment of halitosis due to chronic tonsillitis with caseum and have several advantages compared to conventional tonsillectomy such as reduced post-operative pain and bleeding, shorter recovery time and convenience of an office procedure.

Introduction & Objective: Nowadays, parasitic infections are a major health problem throughout the world, particularly in developing countries. Considering the crucial role of women in family health care, this study aimed to determine the prevalence and associated demographic factors of intestinal parasitic infections in mothers visiting urban and rural health care centers of Hamadan city.Materials & Methods: This cross sectional study was conducted on 253 (128 rural and 125 urban) mothers visiting urban and rural health care centers of Hamadan. After receiving informed consent and filling the questionnaire, stool samples were examined by formalin-ether concentration technique, trichrome and modified Ziehl-Neelsen staining methods. The results were analyzed using Chi-square and Fisher’s exact tests.Results: Of the 253 mothers studied, 52 (20.55%) were infected with intestinal protozoa. The infection rate in urban and rural inhabitants was 14.4% and 26.56%, respectively (P=0.02). Blastocystis hominis was the most frequently detected parasite with prevalence of 14.62%, followed by Entamoeba coli with 5.92%. Moreover, Giardia lamblia was found only in 0.79% of mothers. There were significant relationships between parasitic infections and contact to animals, level of education, location, method of washing vegetables and occupation. Conclusion: The results of the present study showed a high prevalence of parasitic infections in mothers living in rural areas compared to urban inhabitants. Therefore, it is necessary to promote the public health awareness of rural population to reduce the frequency of parasitic infections.

Introduction & Objective: Microorganisms form biomass as biofilm in response to many factors, in order to adapt to hostile extracellular environments and biocides. Using different herbal compounds are of those strategies to deal with biofilm. It has been proved that plants extracts such as pomegranate, raspberry and chamomile essential oils have anti-biofilm effects. This study aimed to evaluate the effect of different concentrations of black peel pomegranate extract on Pseudomonas aeruginosa biofilm formation.Materials & Methods: In this experimental research the anti-biofilm effect, reducing the amount of biofilm formation and growth kinetics of Pseudomonas aeruginosa in different treatments was measured by microtiter and plate colorimetric crystal violet method. Biofilm formation was also examined using a microscope. Statistical analysis of data obtained from the reading of the ELISA was performed using SPSS software, P value 0.05.Results: Findings of this study showed that bacteria cannot form any biofilm in first 6 hours of incubation, in all treatments. The amount of biofilm formation after 12 hours in 0.01 and 0.05 g/ mL treatments were medium. Among treatments, after 18 and 24 hours of incubation 0.001 g/ mL concentration of pomegranate peel extract had medium and strong inhibitory effect on biofilm formation, respectively.Conclusion: Results of this study showed that biofilm formation and biofilm reduction percentage is directly related to the duration of exposure of bacteria that could be due to the different phases of growth. Growth kinetics study also revealed that in the majority of treatments the growth was incremental up to about 15 hours and decrement afterwards due to the effectiveness of different treatments. After 18 hours, treatments have greatest influence on biofilm formation. The foregoing has been fully confirmed by the results of microscopic slides.

Introduction & Objective: Hypernatremia is associated with serious complications in infants. Given the high morbidity and mortality of neonatal hypernatremia, and since some complications can be prevented, this study was aimed to examine the prevalence of hypernatremia in hospitalized infants and related risk factors.Materials & Methods: This cross-sectional study was performed on 1923 neonates hospitalized in Bahrami Hospital affiliated to Tehran University from October 2011 to October 2012. Demographic data , ward ,gender ,mode of feeding ,gravidity, admission season and method of delivery related to the infants were recorded. For infants with a serum sodium above 150 meq/lit, additional information were collected, including serum urea level, gestational age, date of birth, birth weight, admission weight, head circumference and clinical symptoms. Finally, the data were analyzed using the SPSS software.Results: 74 out of 1923 neonates had serum sodium above 150 meq per liter, which their mean Na was significantly associated with their age groups (P=0.04) and weight loss (P=0.008). Furthermore, the mean of urea in these neonates was significantly related to weight loss (P<0.001). The prevalence of hypenatremia in the hospitalized neonates was 5.2% in autumn, 4.9% in winter, 1.8% in spring and 3.4% in summer.Conclusion: The common symptoms of hypernatremia, icterus and weight loss often cannot be evaluated due to late referral (> a few days after birth) or to the non-exact weight at the birth time (risk factors). The study results confirmed that weighing the neonates at 72 to 96 hours after birth can prevent hypernatremia in infants.

Introduction & Objective: 130 heteroxenous species of sarcosytis with different life cycle and pathogenesis have been recognized. The pathogenic species for humans are S. hominis from cattle and S. suihominis from pig that humans are definitive and cattle and pig are intermediate hosts. Some species of Sarcocystis can cause important economic loss and disease in livestock, and health issues in humans. The aim of this study was to determine the prevalence of Sarcocystis infection in slaughtered Cattle and sheep in Hamadan, west of Iran. Materials & Methods: In this cross sectional descriptive study a total of 324 cattle and 334 sheep carcasses were examined using naked eye inspection for macroscopic Sarcocysts, and digestion method, for microscopic types of parasite. Muscles from thigh, heart, tongue, esophagus, diaphragm and costal muscles were examined. All carcasses examined by naked eyes and tissues were minced and poured in digestion medium separately and sediment was examined microscopically.Results: The prevalence of microscopic Sarcocystis in cattle was detected in 100% and there was no macroscopic cyst in examined carcasses. However, the prevalence of microscopic Sarcocystis in the sheep was also 100% and the sarcocysts were found in the 48.34 % of esophagus and 29.49% of diaphragm muscles by naked eyes inspection.Conclusion: The digestion is found the most sensitive method for diagnosis of Sarcocystis. Although 100% of muscles were found infected but the majority of the cysts in the sheep and all in the cattle were as microcysts. That means, the meat should be cooked sufficiently irrespective of meat inspection results.

Introduction & Objective: The antibacterial, antifungal and anti-parasitical effect of selenium and silver nanoparticles have been reported previously. The purpose of this study was to determine the anti-Leishmania healing effect of selenium nanoparticles and silver in lesions caused by Leishmania major in mice.Materials & Methods: In the present experimental study, Balb/c mice were experimentally infected with Leishmania major promastigotes. After the appearance of the lesion in the tail, they were divided into four groups of six. Two groups were treated with selenium and silver nanoparticles by injection in the three-points of the lesion as well as Glucantime per day, for 4 weeks. The mice in the negative control group did not receive any treatment. The diameter of the wound and body weight of the mice was measured every day for 5 weeks.Results: The diameter of the lesions in the group treated with nanoselenium was not different with the untreated control group. The diameter of the wounds treated with nanosilver was significantly different with the control group without treatment, but was larger than the group treated with meglumine antimoniate.Conclusion: Unlike selenium nanoparticles, silver nanoparticle showed anti-Leishmanial effect in vivo. Like Glucantime, it did not heal leishmanial lesion entirely.

Introduction & Objective: Although several dietary factors have been reported to alleviate or aggravate the symptoms of irritable bowel syndrome (IBS), no information is available linking dietary patterns to irritable bowel syndrome. Objective: This study was undertaken to assess the association between dietary patterns and the risk of irritable bowel syndrome among Iranian adults.Materials & Methods: In this cross-sectional study, data on 3846 Iranian general adults working in 50 different health centers were examined. Dietary intake of the participants was assessed using a 106-item self-administered Dish-based Semi-quantitative Food Frequency Questionnaire (DS-FFQ) which was designed and validated specifically for Iranian adults. A modified Persian version of the Rome III questionnaire was used for assessment of FGIDs, including IBS, which was defined according to ROME III criteria. To identify major dietary patterns based on the 39 food groups, we used principal component analysis.Results: We identified four major dietary patterns: 1) “fast food” dietary pattern; 2) “traditional” dietary pattern; 3) “lacto-vegetarian” dietary pattern; 4) “western” dietary pattern. After adjustment for potential confounders, we found that those in the highest quartile of “fast food” dietary pattern tended to have higher risk of IBS than those in the lowest quartile (1.32; 0.99, 1.75, Ptrend=0.05). An inverse association was found between “lacto-vegetarian” dietary pattern and risk of IBS; such that even after adjustment for potential confounders, those in top quartile of this dietary pattern were 24% less likely to have IBS (0.76; 0.59, 0.98; Ptrend=0.02). No overall significant associations were observed between “traditional” and “western” dietary patterns and risk of IBS, either before or after adjustment for covariates.Conclusion: We found that “lacto-vegetarian” dietary pattern was associated with reduced risk, while “fast food” dietary pattern was associated with a greater risk of IBS in Iranian adults.

Introduction & Objective: The possible link between anxiety disorders, such as social anxiety, and neuropsychological functioning has received much less attention. The present study was set out to investigate the effect of social anxiety on one of the executive performances, that is, shifting function. Also, performance in this function is investigated with regard to processing efficacy and performance effectiveness.Materials & Methods: For this purpose, in 2012-2013, 24 patients with social anxiety disorder and 24 non patients in multi-stage sampling method were recruited and tested by clinical interview, connor social anxiety scale, self-reported mental effort scale, Wisconsin card sorting test, The results were analyzed with mixed repeated measures, modified bone ferreni post hoc test, and independent T- test.Results: Under basic and induced anxiety conditions the results showed that there were significant differences between groups in processing efficacy (P<0.001). But for the performance effectiveness in the basic condition there were significant differences just in two subscales: number of categories completed and the total number of errors. In the induced anxiety condition there were significant differences between groups in all subscales performance effectiveness (P<0.001).Conclusion: Working memory in the social phobia patients was impaired, as compared to that of the healthy controls. Working memory deficiency observed in social phobia might be related to assumptions about social phobia cognitive model. This model suggests that individuals with social phobia cannot shift their attention to external stimuli in social situations.

Introduction & Objective: Health literacy is the degree to which individuals obtain, interpret and understand basic health information and services to make appropriate health decisions. The aim of this study was to describe health literacy of Bu Ali Sina university staff to help health care policy makers for proper interventions.Materials & Methods: In this descriptive-analytical study, health literacy of 206 employees was measured using a researcher-made questionnaire. Health literacy about risk factors of cardiovascular diseases, cancers and diabetes was measured in 7 areas including: “attitude to health”, “understanding the information”, “social support”, “socio-economic conditions”, “access to health services", "communication with health professionals" and “application of health information”.Results: Median of overall health literacy level in identification of risk factors for all three diseases was 3.7, and median of health literacy level in “identification of risk factors” for heart diseases, diabetes and cancers were reported 3.53, 3.44, and 3.58, respectively. Except for cancer, health literacy levels about identification of cardiovascular disease and diabetes risk factors were significantly higher in women (P= 0.02). Educational level increase showed a significant rise in health literacy score (P= 0.008).Conclusion: As a whole, 75.2% of cases had inadequate health literacy about risk factors of all three diseases. The lowest level of health literacy was related to the” application of health information”. So, regarding the importance of health literacy and its link to health outcomes, it seems that policy makers need to pay more attention to health literacy improvement, particularly in the “application of health information”.

Introduction & Objective: Iran is among the countries with a variety of scorpion species, particularly dangerous ones. Death due to scorpion sting occurs in all parts of the country. Mortality from scorpion sting depends on various factors such as scorpion species, age of the stung person, stung body site and geographical area. Considering the fact that so far no research on the fauna and epidemiological aspect of scorpion stings has been done in Hamadan city, we conducted this research.Materials & Methods: This is a cross sectional- descriptive study. To determine the scorpion fauna of the region using a random cluster sampling in specified locations from May to September in 2013 and was attempting we caught scorpions and put them in containers of alcohol (70%) and identified them based on Iran scorpions´ key. In order to investigate cases of scorpion stings, we referred to the health center of Hamadan province and using questionnaires, we collected data related to the patients during 2010-2013. The data were analyzed by SPSS software.Results: A total of 98 collected scorpion species named Mesobuthus eupeus, Androctonus crassicauda, Odontobuthus doriae and Razianus zarudnyi (Family: Buthidae), were identified. Mesobuthus eupeus species with 89.7% of the samples collected had the highest frequency. Totally, 797 cases of scorpion sting were documented in the Health Center of Hamadan Province, including 498 (62.5%) male and 299 (37.5%) females. The results of this study showed that most cases of scorpion stings in the age group of 25 to 34 years, in 2011 in July and in the rural areas were 29.6%, 33.1%, 28.9%, 64.4%, respectively. The most stung organs were hands, with 48.2%. All patients (100%) during the study were treated.Conclusion: Due to the low-risk species of scorpions in the region and lack of mortality reports in the past few years, it is recommended to revise administering anti-scorpion serum in the health centers. Adequate training and awareness related to scorpions and prevention is the first step in reducing scorpion sting.

Introduction: Caroli disease is a rare congenital disorder characterized by segmental, nonobstructive dilatation of intrahepatic bile ducts. The term Caroli syndrome is used for the association of Caroli disease with congenital hepatic fibrosis.Case Report: A 37 year old woman, a diagnosed case of Caroli syndrome, was admitted to hospital because of fever, cough and sputum. During the clinical examination and imaging, thoracic empyema and lung abscess was seen in the right hemithorax. Also, pneumobilia was seen in abdominal CT scan.Conclusion: Tube thoracostomy was done but lung did not expand. Therefore, right thoracotomy was performed. Intraoperative finding was as fallows: because of biliary tract infection and abccess formation the tracts were fistulated to the lung parenchyma and pleural space. Irrigation and drainage was performed. After 2 weeks the patient was discharged. He was being fallowed up for 1 year after the surgery and no serious problem was observed.