Avicenna Journal of Clinical Medicine
Year:2012 | Volume:18 | Issue:4 (SN 62)|Papers Count:14

Introduction & Objective: It is clear that tooth extraction is painful. Different drugs with various functions have been used in order to relieve the pain after extraction. Ibuprofen is a non-narcotic analgesic and acetaminophen is considered as one of the most consumption anti-inflammatory drugs and is administrated to relieve moderate to severe pains. Our purpose is comparing the effects of acetaminophen, ibuprofen and combination of them to relieve the teeth pain due to extraction under local anesthesia.Materials & Methods: In this randomized clinical trial, we divided 105 children (6-11 years old) referred to pediatrics ward of dental faculty of Hamadan University into 3 groups of 35 after getting their parent's consents, taking, their history and weighing them. Group1: received acetaminophen syrup with dose of 15mg/kg, group2: received ibuprofen syrup with dose of 5 mg/kg, and group3 received acetaminophen syrup with dose of 7.5mg/kg and ibuprofen syrup with dose of 2.5 mg/kg. One hour before and 15 min after tooth extraction, severity of their pain was evaluated according to table (CHEOPS).Drug effects in every group was studied by x2 , t-test and Mann Whitney U test.Results: Age average of the children under survey in the group of acetaminophen syrup was 8.62 ± 1.81 years old and in the group of ibuprofen syrup was 8.45 ± 1.68 years old, and in the group of acetaminophen with ibuprofen was equal with 8.71 ± 1.27 years old. Sex combination of the under survey children in the group of acetaminophen syrup was 51.4%/ 48.6% (female/ male), in the group of ibuprofen syrup was 51.4%/ 48.6%, and in the group of acetaminophen syrup with ibuprofen syrup was 65.7%/ 34.3%. Grade average of toothache immediately after extraction in the group treated with acetaminophen syrup was 33.19 and, in group treated with ibuprofen syrup equaled 37.81, and in the group treated with acetaminophen syrup with ibuprofen syrup was 47.86. Grade average of toothache 15 min after extraction in the group 1 was 35.1, in the second group was 35.9, and in the third group was 40.83.Conclusion: The group received ibuprofen syrup and in the group received acetaminophen syrup in comparison with the group received acetaminophen with ibuprofen on the instant and 15 min after extraction showed much more relieved effect (P<0.05). No meaningful statistic differences were observed between the group received acetaminophen I5 mg/kg and the group received ibuprofen 5 mg/kg.

Introduction & Objective: Diabetes mellitus is a common disease that almost 1.5 million people in Iran are affected, Regarding to the adverse effects of chemical drugs, the tendency to use medicinal plants, among which nettle was chosen to be studied, is growing. In this research the effect of hydroalcoholic extract of nettle on insulin sensitivity and some inflammatory factors in type II diabetic patients were studied.Materials & Methods: A blind randomized clinical trial on 50 men and women with type 2 diabetes, (mean age: 52.39±13.75) was designed to determine the aforementioned effect. Patients were randomly divided into intervention and control groups who received 100 mg/kg, Nettle extract or placebo respectively three times a day for 8 weeks. Fasting Insulin and some inflammatory factors (Interleukin-6 (IL-6), Tumor Necrosis Factor- a (TNF- a), and hsCRP (High Sensitive C-Reactive Protein) levels at the beginning and end of the study were measured.Results: IL-6 and hsCRP showed a significant decrease (P<0.05), TNF-a, insulin sensitivity and hsCRP showed no significant change at the end of the study in the intervention group compared to the control. Statistical analysis was performed with SPSS software version 18 and P<0.05 was considered significant for all measurements.Conclusion: The hydroalcoholic extract of nettle showed significant decrease in IL-6 and hsCRP after 2 months of intervention in patients with type 2 diabetes.

Introduction & Objective: Relationship between overweight being and obese with metabolic risk factors of the cardiovascular disease in adolescent boy considering the variety and irregular motional patterns, has attracted the researchers' attention. The aim of this study was to investigate biochemical and anthropometrical risk factors of the cardiovascular system, daily physical activity (steps/ day) and aerobic capacity of overweight and normal weight adolescent boys.Materials & Methods: Fifty six adolescent boys were recruited in two groups, over weight-obese as a risk receptive group (n=28) and normal weight (n=28). Blood lipids, daily steps (physical activity volume), body composition and aerobic capacity were measured with standard methods.Results: TG, TC, LDL-C and VLDL–C concentrations and TC/HDL-C and LDL-C/HDL-C in the normal weight individuals were significantly lower than the overweight subjects (P<0.05 and P<0.005 respectively). The Aerobic capacity of normal weight was better than overweight-obese ones (P<0.001). The Mean of Daily steps of overweight group (12617±868 steps/day) was significantly lower than normal weight group (14941±1159 steps/day) (P<0.001).Conclusion: It seems that living an active life (14941±1159 step day) can reduce biochemical and anthropometrical risk factors of the cardiovascular disease.

Introduction & Objective: Acinetobacter baumannii is an important nosocomial pathogen all over the world and has emerged as a threat to public health which also exhibit multiple-antibiotic resistance. Studies of antibiotic resistance mechanism in these bacteria have demonstrated the presence of specific antimicrobial resistance genes located mainly in integrons. The purpose of this study was to search for the presence of the class 2 integron in strains of A. baumannii found in Tehran-Iran and the relationship between the presence of this integron and the antimicrobial susceptibility patterns.Material & Methods: This cross sectional study was performed in three main hospitals in Tehran on 500 clinical samples during a 10 month period (March to December 2010). In laboratory, after identifying the species of A. baumannii by using culture and biochemical methods, disc diffusion method according to CLSI guidelines was performed to determine the sensitivity of 50 isolates of these bacteria to 13 antibiotics. Polymerase chain reaction (PCR) was performed for the detection of integron class 2 by Int2F/R primers. Eventually correlation of multi-drug resistance and existence of integron class II were studied.Results: Of these 500 samples, 50 (71.5%) strains of A. baumannii, 12 (17%) A. lwoffii strains and 8 (11.5) other Acinetobacter species were isolated. The most common resistance detected among 50 isolates was to Cefepime, Ceftazidime, Aztreonam, Norfloxacin, Ciprofloxacin, Ofloxacin, and Amikacin. Also, less resistance was observed to imipenem, Gentamycin, Ampicillin- sulbactam, Piperacillin-Tazobactam. Meropenem and Tobramycin were considered as effective drugs in this study. Class 2 integrons were found in 41 (82%) of the 50 isolates of A. baumannii. Moreover, a significant correlation between integron class2 and resistance to antibiotics of Cefepime, Ceftazidime, Aztreonam, Norfloxacin, Ciprofloxacin, Ofloxacin, and Amikacin were observed.Conclusion: Our findings indicates that class 2 integron are widely spreads among A. baumannii isolated in Tehran, Iran and plays an important role in multidrug resistance in these bacteria. Therefore, monitoring drug resistance due to integron class 2 by PCR, in protocols of infection control due to multidrug-resistant A. baumannii in hospitals of Tehran is important.

Introduction & Objective: Melatonin, the most important secretary hormone of pineal gland, as a powerful antioxidant has a high potent for neutralizing the toxicity of drugs. In the present study we aimed to demonstrate the effect of melatonin on testicular damage and sperm parameters deficiency induced by acetylsalicylic acid, in adult male mice.Materials & Methods: Male NMRI mice were divided into 4 groups: 1) control 2) acetylsalicylic acid treated group 3) melatonin treated group 4) Melatonin-acetylsalicylic acid treated group. Acetylsalicylic acid was administered at a dose of 50mg/kg orally through gavage for 14 days. Melatonin was administered in dose of 10 mg/kg for 5 days intraperitoneally. The control mice were received vehicle (normal saline) orally through gavage. The animals were sacrificed and their testes and epididymis were dissected on the 15th day after the treatment. Evaluations were made by determining Johnson's score, epididymal sperm count, and sperm morphology and sperm motility. Statistical analysis was performed by ANOVA test.Results: Acetylsalicylic acid treated mice showed a reduction in Johnson's score and quality of spermatogenesis (P<0.05), sperm count, normal morphology and motility percent (P<0.001), compared to the control. Melatonin in group 4, significantly increased maturation of seminiferous tubules (P<0.05), and quality and quantity of sperm parameters (P<0.05) in comparison with group 2.Conclusion: It seems that intraperitoneal administration of melatonin for 5 days is a potentially beneficial agent to improve the quality of spermatogenesis and sperm parameters in testis damaged by acetylsalicylic acid, probably by decreasing oxidative stresses.

Introduction & Objective: The aim of the present study is to determine the accuracy of malignancy prediction in adnexal mass if CA125 measurement is added to sonographic findings.Materials & Methods: In a cross sectional study, AUC of ROC Curve of malignancy prediction based on sonographic findings in comparison to a new model (OMPS2) based on sonography plus serum CA125 was calculated. Pathologic reports of 430 operated adnexal masses were included in the study. Logistic regression analysis was used.Results: New model (OMPS2) was constructed as follow: OMPS1+1.444 (if CA125=36-200) or 3.842 (if CA125 is above 200).AUC of ROC curve of malignancy prediction increased from 78.1% (based on OMPS1) to 84.3% (in OMPS2).Conclusion: Serum CA125 measurement in addition to sonography increased the accuracy of malignancy prediction in comparison to only sonography.

Introduction & Objective: Needlestick and sharps injuries (NSSIs) is an important occupational risk among health care workers (HCWs), and it is an important cause of transmission of blood-borne pathogens to this population. The aim of this study was to determine the rate of NSSI among HCWs in the teaching hospitals in Hamadan.Materials & Methods: This cross-sectional study was carried out on 700 HCWs between 2009 and 2010. A questionnaire was designed for data collection. Questionnaires were distributed in 5 hospitals to collect self-reported NSSI in the past 12- months.Results: The rate of accidental NSSI was 24.1% for one year prior the study. Totally, 83.6% of the participants had a full vaccination course against hepatitis B. The majority of NSSIs occurred in the 30-34 age group (33.3%) and most of them were female. Also, 48.5% of NSSIs were during blood sampling or IV catheter insertion.Conclusion: Developing appropriate educational programs regarding prophylactic tasks, disposal of medical wastes, and using safe needle devices can reduce the risk of NSSIs among HCWs.

Introduction & Objective: Cutaneous Leishmaniasis is caused by obligatory intracellular parasite of genus Lieshmania. The disease is reported from more than half of Iran' s provinces. Various species of sand flies are vector of the disease. Determination of vectors and gaining knowledge about them are important for devising of control program.Materials & Methods: This survey was performed as a cross-sectional study in order to determine the vector (s) of cutaneous leishmaniasis in Damghan district during 2008-2009. Sand flies were collected from indoors and outdoors by sticky traps twice in month from April to November. Head and last abdominal segments of the samples were removed and mounted in a drop of Puri’s medium and identified. The rest of the sand flies' bodies was subjected to DNA extraction for molecular detection of Leishmania parasite by Nested PCR using specific primers of minicircle kinetoplast DNA Results: Totally, 6110 sand flies in 8 species were collected. P. papatasi had high density (46.7%). Examination of 280 female sand flies by Nested PCR showed that 28 sand flies (10%) include 24 specimens P. papatasi (85.7%) and 4 specimens P. caucasicus (14.3%) were found naturally infected with L.major. The highest rate of infected sandflies were observed in rodents burrow (42.9%). Maximum rate of sand fly infection was in September (89.3%).Conclusion: With respect to high density of P.papatasi and isolation of L. major from it, this species was the main vector of the disease. Detection of L. major from P. caucasicus shows that this species was the secondary vector in rodent burrow. The highest rate of sand leis infected was in September, so personal protection in this month is very important and necessary. Regarding to the high density of vectors and high infection rate of them taking actions to decrease the sand fly abundance and prevention of human biting are suggested.

Introduction & Objective: There are varieties of interventions to treatment of ADHD, among which drug therapy, behavior therapy, parental management training and neurofeedback can be cited. The present study designed to investigate and compare the effectiveness of neurofeedback and Ritalin on improving conduct problems and hyperactivity.Materials & Methods: Quasi-experimental research method with pretest-post test design has been applied in the research. Statistical population of the study consisted of ADHD children of Tehran. The study samples of the study were patients referred to children psychiatric clinic. Based on the purpose of the study' 20 children were randomly selected and classified into 2 groups according to random assignment. CPRS-48 (parent form) was administered by parents before and after the treatments as research tools. Recruited data was analyzed by SPSS-19 in two sections of descriptive and inferential statistics. ANCOVA revealed some differences in the groups.Results: The findings of the study showed that there was a significant difference between Ritalin and neurofeedback on improving conduct problems, in other words, Ritalin was more effective in alleviating the problems. Also there was no significant difference between the interventions on improving hyperactivity index.Conclusion: With respect to more efficiency of Ritalin than neurofeedback on certain continuum of signs/symptoms of ADHD, as a whole, preferences of interventions should be based on type, magnitude and severity of the syndrome.

Introduction & Objective: Depression is the most common psychiatric disorder reported among college students. Evidence suggests that depression rate is especially high among medical students. The goal of this study was to examine the relationship of general self-efficacy and social support with depression levels of university students.Materials & Methods: This was a descriptive analytic study carried out among 235 students in Hamadan University of medical sciences. Samples were classified with the appropriate assignment done and gathering information from standard questionnaires (Beck Depression Inventory test & General Self Efficacy Scale & Perceived Social Support Scale). The data were analyzed by SPSS-13.Results: 37 percent of students showed different degrees of depression. A significant negative correlation was found among depression, self efficacy (P. value=0.000, r=-0.581), and social support (P. value=0.000, r=-0.617). Also the results showed that there was significant relationship between depression and student's dwelling (P<0.05).Conclusion: These findings also indicated the potential roles of social support in mediating depression. According to the results self efficacy strategies could improve the students' mental health.

Introduction & Objective: The present study aims to achieve a comprehensive depiction of ecstasy consumption among the students of Urmia University of medical sciences in 2007.Materials & Methods: Totally 950 students were surveyed in this cross-sectional descriptive study. A census was used as a sampling method. A self-report questionnaire regarding demographic details and ecstasy consumption was completed by students. Data was stored in a database and then was analyzed through descriptive tests by SPSS software. Chi square test was used to determine the correlation coefficient.Results: There were 798 subjects of all target population who had never used this drug. However, 132 subjects (18 regularly, 56 occasionally for fun and 58 at least once) consumed ecstasy pills. Thus the point prevalence of ecstasy consumption among the students was 14.19 percent. There were 232 subjects who had never heard of the term "ecstasy". Instead, the knowledge source of the rest about ecstasy was books (116 subject), internet (56 subjects), mass media (489 subjects), friends (28 subjects), and family (2 subjects). A significant relation was observed between ecstasy consumption and other variables (parents' education, residence in student campus, attending parties, smoking, canabis and opium consumption).Conclusion: Results of this study revealed that the point prevalence of ecstasy pills consumption among university students was 14.19% that raises the need for purposive intervention and the necessity of planning to prevent and decrease this phenomenon.

Introduction: Methanol is a toxic material and is found as an ingredient of many products, such as anti freezes and washer fluid. Acute poisoning is a rare accidental or suicidal intoxication or occurs after ingestion of alcohol. Methanol poisoning can cause severe metabolic acidosis, neurologic dysfunction, visual loss, parkinsonism, and death. Basal ganglia necrosis, and subcortical white matter lesions are the most frequent CT scan and MRI findings.Case Report: Our patient is a 20 year old man, who was brought to the emergency department with decreased level of consciousness several hours after ingestion of alcohol. Brain CT scan and MRI findings were bilateral putaminal necrosis, and subcortical white matter lesions. Parkinsonism, paraplegia, polyneuropathy were the side effects. However, he is bedridden at home with nursing care and suffers from persistent neurologic sequelae.Conclusion: Alcohol abuse is one of the causes of methanol toxicity. Due to the late effects (after 12-24hrs) and delay in hospital referring, CNS sequelae and parkinsonism syndrome or paraplegia or polyneuropathy can occur. The best treatment is prophylaxis, that is achievable through education and giving more information. The side effects are irreversible that highlight the importance of prophylaxis.