Avicenna Journal of Clinical Medicine
Year:2004 | Volume:11 | Issue:1 (SN 31)|Papers Count:15

Hypothermia in nature occurs in hibernating animals. It has applications in medicine in open heart surgery, organ and connective tissue preserving, altitude medicine and geriatrics. Despite the vastness of studies on hypothermia many of its biologic and physiologic effects including endocrine system alterations are still poorly recognized. In this study the effect of hypothermia on renin- angiotensin-aldosterone axis was explored. Ten male wistar albino rats (mean age 5 months) were anesthetized by intraperitoneal injection of chloralhydrat (0.5 m1/100gr body weight). Then animals were placed in hypothermia apparatus. Their body temperature were reduced to 25°C. AngiotensinI(ANGI) and aldosterone (ALD) levels of serum were measured by radioimmunoassay before and after hypothermia induction and once every 24 hours for three days. Plasma renin activity (PRA) was also measured by using the standard formula of angiotensin determinates at two temperatures of 4°C and 37°C.The results showed that PRA, ANGI and ALD increased significantly immedietly after hypothermia (p<0.03). Later changes were followed as these factors decreased to basal level, except in the case of aldosterone which maintained its increased level significantly for 24 hours (p<0.05).It seems that moderate hypothermia have stimulatory effect on PRA, ANGI and ALD that results of this study confirm it.

Phenanthrolines are a group of organic compounds which can transfer metal ions through the plasma membranes of the cell. Due to their ionophoric characteristics, phenanthrolines are widely used in chemical and boilogical studies. In this research, the effect a new chelating agent 2,6 diaminopyridinum (1,10-Phenanthroline-2,9- dicarboxylate) which was synthesized in organic chemistry laboratory of Teacher Training University of Tehran city , on the pituitary - gonad axis was studied. It was decided to find out the effects of this compound on the pituitary- gonad axis and testis tissue of adult Balb/C mice. LD50 standard was found 35mg/kg B.W. Some doses of 15, 20 and 25 mg/kg of body weight were injected as sublethal doses of compound and continued for 20 days intraperitonealy, while the control groups received the solvent (normal saline).The results showed that 25 mg/kg B.W. of the compound decreases testosterone level in the blood serum significantly (68.5%) but no significant changes were obtained in LH and FSH levels in experimental and control groups. Also low doses of 15 and 20 mg/kg B.W did not change the hormonal levels significantly. Histological investigations on the testis tissue showed that the number of sperm cells in doses of 15, 20 and 25 mg/kg B.W decreased 20.2%, 52.1% and 95.2% and did not showed any harmful side effects on the animals. According to the results of this study, it may concluded that this phenanthroline derivative in high dose decrease the level of blood serum testosterone and spermatogenesis.

The possible health effects of chronic exposure to petroleum products, in particular exposure to gasoline is an issue of public health concern. Filling station workers are at great risk of exposure to gasoline. To determine the health effects of gasoline exposure on filling station workers, a cross-sectional study was conducted in Shiraz on 56 male gasoline workers and 56 age and sex matched control subjects with no occupational exposure to gasoline. Renal function test was done in the study population. To elucidate the role of hepatic detoxifying enzymes, the genotypes of glutathione S-transferases (GST) M1 and T1 were determined. Data analysis was done by multiple regression and nonparametric Kruskal- Wallis test. Results showed that all measurements were in normal range, although subclinical changes were detected in some indices. The present results showed that exposure to gasoline was associated with increased serum creatinine (t=3.33, P=0.001). No difference was detected for this finding in workers with different GST genotypes. Overall due to detection of subclinical changes in renal tests in gasoline station workers, exposure limitation and administrating safety devices is recommended. Also for monitoring health status of workers, doing baseline renal tests and repeating them in appropriate interval is suggested.

Behcet's syndrome is a generalized vasculitis with unknown cause. Acute recurrent iritis, retinal vasculitis, retinal hemorrhage, macular edema, retinal necrosis, ischemic optic neuropathy and vitritis are the most common ophthalmologic involvement. The aim of this study was to determine the frequency of ophthalmologic involvement in patients with Behcet syndrome who referred to ophthalmology clinic of Imam Khomeini hospital in Hamadan city during May 2002-February 2003.This research was a prospective cross-sectional study on 28 patients suffering from Behcet's syndrome. All of the patients were examined by slit lamp and direct and indirect fundoscopy and evaluation of visual acuity. The required information from each patiens was recorded in a checklist.19 patients were male and 9 patients were female. The most common age of the patients was the 4th decade. The first sign was oral involvement (64.3%). Ophthalmologic involvement was observed in 20 patients (71%) overall. Cataract was in 8 patients, pigmentation of lens was in 3 patients and post subcapsular cataract in 2 patients, post synechia was in 11 patients, Ant. uveitis was in 2 patints, post uveitis was in 3 patients and panuveitis was in 8 patients, 3 patients had hypopyone, 11 patients had vitritis, 8 patients had ischemic optic neuropathy, 8 patients had retinal necrosis, 8 patients had retinal vasculitis, 5 patients had retinal hemorrhage and 5 patients had macular edema. Visual acuity of 5 patients was NLP (blindness) due to Behcet's syndrome.This study showed that Ant. uveitis and cataract had the high frequency and post. uveitis and panuveitis had low frequency and other manifestations of subjects approximately were equal compared with other reports.

The aim of this study was to determine whether there is any different in hCG levels of vaginal fluids from normal pregnant women, women with confirmed PROM and with suspected PROM.After irrigating the posterior vaginal fornix with 3 ml of sterile saline and procuring vaginal washing, we measured hCG levels. Samples were analyzed from 38 normal pregnant women , 31 women with confirmed PROM, 28 women with suspected PROM.The mean of vaginal fluid hCG levels of normal pregnant women were 11.2 (0.00-98.6) mIu/ml. That of women with PROM was 140.2 (0.5, 390.1) and that of women with suspected PROM was 21.5 (0.0, 143.9). Sensivity was 80%, specility 83%, positive predictive value 73.7%, negative predictive value 88.1%, using a cut-value 20.It was concluded that the hCG level in vaginal fluid is a marker of PROM during third trimester.

Although, it is known that feeding with carbohydrate (CHO) during exercise improves endurance performance, the effects of glycemic index (GI) of carbohydrate intake are less clear. This study was carried out to assess the effect of glycemic index of pre-exercise carbohydrate feeding on endurance exercise capacity. In a randomized clinical trial 52 endurance - trained men with mean age 21.7 ± 3 years, weight 69.3 ± 9 kg, height 178.4 ± 2 cm and BMI 22.6 ± 2 were studied. Subjects performed exercise treadmill at 70% VO2max after ingestion: Lentil, a low glycemic index; potato, a high glycemic index; glucose and water (as a control) one hour before exercise. Blood samples were collected before and one hour after test meal and 30 minutes after exercise. To assess aerobic capacity VO2max (maximum oxygen uptake) was measured at the end of the exercise trial. Endurance time was found to be longer after lentil than after the potato, glucose and control respectively (P < 0.05). At the end of exercise, the glucose group and control both gave lower plasma glucose concentrations. Changes of VO2max in lentil. Potato, glucose and control group which were not statistically significant. This study showed that a low GI meal eaten before an event increases endurance capacity during exercise. Furthermore, the low GI meal was found to maintain glucose at higher concentrations during the later stages of exercise.

The overall objective of this study was to determine TQM application in health systems of different countries and designing an appropriate model for Iran through experimenting in Hamadan Province District Health Systems. Its most important special objectives were: analyzing action plan for TQM and the achievements in different countries -including IRAN, primary modeling TQM and proposing it for health systems, experimenting of the mentioned above model in 8 DHSs` of Hamadan province , analyzing the results of applying TQM and at the end proposing appropriate strategy for successful implementation of TQM.This research was a semi exprimental study that after one year from applying proposed model in 8 DHSs` of Hamadan Province short-term results were evaluated. The results showed a positive change in organizational culture, teamwork, process oriented and customer satisfaction in the trial field. In a way that 42.5% of responses agreed with cultural change in organization, 45.5% claimed increasing of teams problem solving effectiveness. As a necessiation technical aspect of quality improvement projects, process capability ratio (PCR), in some process was dramatically increased, in a way that PCR in vaccination process (from 0.8 to 1.08) , health card issued (from 0.82 to 1.71), child care(from 0.5 to 1.3), health house reports(from 0.24 to 1.5) and delivery of LD&HD pill (from 0.41 to 1.48) improved. The most driving forces capable of affecting success of TQM were: committed and supportive management (87%), continuous education (85%), Strategic planning (73%),and Employee participation (65%).Considering the maintained above results, TQM implementation in Hamadan province district health systems, not only increased quality of key processes, but also created positive culture change.

Diaper dermatitis (Diaper rash) is the most common cutaneous disorder of infancy and childhood. Although the etiology of this condition remains unknown, an amalgam of various causes (mechanical friction, moisture, contact with urine and feces, variation of skin pH, fungal infection) bring about this common dermatitis. Because most diaper dermatitis is treated conservatively at home, the frequency is unknown, but from 7%-35% up to 50% has been reported. Therefore the frequency of diaper dermatitis and related aggravating factors in 1-2 years old children was studied at nursing home of Hamadan at year 2000-2001.The study was cross-sectional, descriptive on 385 children using randomized selection and data was collected by questionnaire and completed by direct observation.In this study 79 (20.5%) subjects had diaper dermatitis, there was meaningful association with" educational level of mother, age of child and use of disposable diaper (p<0.05)" . There was no meaningful relation with sex. The most prominent region of involvement was combination of perineum -genitalia-buttock-thighs.For better controlling of diaper dermatitis we should consider the proper health education for mother and nursing home instructors, and using of super absorbent diapers.

Dyspepsia is one of the most common entities referred to physicians by variable complaints including epigastric discomfort, upper abdominal fullness , heartburn, retching, nausea, vomiting and bloating. Frequency of Dyspepsia in different countries varies from 25% to 40% in general population. High costs in diagnosis and managements of Dyspepsia means this disease should be concerned at the top of priority in health - related problems. Therefore the aim of this study was to determine the prevalence of functional dyspepsia in rural individuals.2700 persons from all rural districts of hamadan having ages above 15 years old were enrolled. Sampling was clustered randomized and a questionnaire was filled by researchers physicians.Frequency of dyspepsia in rural districts showed 18%.21% in females and 14.7% in mens. 65% of dyspeptic patients were in 15-34 years old group. Fullness or epigastic discomfort was the most common symptoms (86.6%) and nausea &vomiting was the least common symptoms (37.2%). We concluded that the frequency of Dyspepsia in rural areas of Hamadan is significant.

Urinary infection is a predisposing factor of preterm labor and preterm infant has high mortality & morbidity. We have studied effect of urinary infection on preterm labor in a case-control study in Fatemieh hospital of Hamadan in 1999.The population enrolled in the study consisted of 80 patients admitted in hospital for preterm labor and the 80 subjects who were reffered for the normal and term delivery. From the beginning of the study we selected the patients who were admitted for preterm labor and had the condition for enrolling the study and took the information needed out of their fields and filled the questionnaire. Also the patients who had a term pregnancy and had the required condition were enrolled the study randomly. U/A & U/C tests were taken from all of the patients and the result were recorded.The frequency of positive U/C in the preterm labor subjects was 3 fold higher than that of control group (P value<0.05). The observed microorganism was E.coli. There was not any meaningful statistical difference in the frequency of clinical symptom between two groups (P. value>0.05). In conclusion, as this study indicated urinary infection hasn't any important effect on preterm.

Ascaris lumbricoides is the most common intestinal parasite in the world. Various studies has indicated the high prevalence of this parasite in Iran, specially in the west parts of Iran. The epidemiological study of intestinal parasitic infection is prerequisite for planning of control programs. The Hamadan province is one of the most tourist attraction regions of Iran and providing a safe environment for travelers is the main aim of regional authorities. A mass chemotherapy for Ascariasis performed in rural areas of Hamadan province for a five years period but, no any intervention was done for control of this parasite in the Hamadan city. Therefore, an epidemiological study of Ascariasis in this town was necessary.A cross sectional study carried out by cluster random sampling in Hamadan and 580 stool specimens collected from different parts of city. The stools were examined by formalin ether concentration technique for ova and parasites and intensity of infection was determined by quantitative modified Stoll method.Mean infection rate of Ascariasis was 19.5%. The Farhangian suburb (northern part) had higher infection rate than other parts (28.5%) and central parts of city showed lower infection rate (12.7%). The highest infection rate were found in the 31-40 years age group (33.8%) and in the females(23.9%).In view of intensity, 59.3% of infections were moderate and 48.3% had low intensity. No any high intensity were found. Mean egg per gram (epg) were 7129 and 48.7% of eggs were infertile.This study indicated that , prevalence of Ascaris in Hamadan city is considerable at present and a suitable intervention, like health education and selective chemotherapy is necessary to decrease the infection.

Maxillary sinus mucocele is very rare in the Para nasal sinuses and sinus surgery e.g. Caldwell-luk surgery is the most common its etiology and other causes are congenital, mucosal retention, inflammatory, infectious and post traumatic.This study reports one case maxillary sinus mucocele with expansion to nasal cavity in 55 years old man that was undergone endoscopic sinus surgery and then fallowed up for 9 months that middle meatal antrostomy was patent and patient reported resolution of symptoms and hadn't recurrence.