Avicenna Journal of Clinical Medicine
Year:2008 | Volume:15 | Issue:1 (SN 47)|Papers Count:16

Introduction & Objective: Although many studies have been conducted in Iran, but because of the importance of suicide problem in the mental health programs, it is still necessary to do some epidemiologic study. This study has addressed to suicidal behaviors rates in a community sample of Karaj city.Materials & Methods: Karaj with 1,000,000 population was selected as the environment of study. Our subjects (no=2300) were 15 years and older that were selected by randomized sampling. SUPRE-MISS questionnaire was employed in this survey.Results: 65% of the subjects were female, 57.2% of them were married, and most of them had high school level of education (48%). Housewife women were the most common category among occupational groups (43.3%). According to the results the prevalence of positive history for suicide behaviors (idea, plan, attempt) were 12.7%,6.2% & 3.3% respectively, and for current year were 5.7%, 2.9% & 1%.Conclusion: Suicidal behaviors in Iran, in spite of suicide leading to death, have similar prevalence to western countries.

Introduction & Objective: Sleep quality can affect human health and daily function. On the other hand, every person has relatively stable personality trait which lives with and has occupational, social and interpersonal interaction. Regarding the importance of sleep quality, and because less considerations have been devoted to correlation between sleep disturbances and personality traits, the present investigation was done. The purpose of this study was to determine personality traits and sleep patterns among medical students in Hamadan medical university and the relationship between traits in question sleep patterns as well.Materials & Methods: This descriptive and Cross - Sectional study involving 150 randomly selected medical students. Pittsburgh questionnaire, MMPI and a checking list for demographic information were employed. Data processing and statistical analysis were performed using SPSS10.Results: The findings of this study have showed that 48 percent of our cases have suffered from sleep disturbances. The number of personality traits such as narcissistic, histrionic and borderline (cluster B) observed among students had greater frequencies than other traits. The average of night and day sleep time was 8.95±2.01. No meaningful correlation has been found between sleep disturbances and personality traits in our cases.Conclusion: A great number of medical students suffer from sleep disturbances, because it may highly affect student's health and their daily function. More and wider studies should be done.

Introduction& Objective: Patients with Major depressive are difficult to treat, and the relative efficacy of medications and cognitive therapy in the treatment of depression is still a matter of deabath. The purpose of this study was to compare the efficacies of antidepressant medication, cognitive therapy and combination of cognitive therapy and antidepressant medication.Materials & Methods: In an experimental study, 120 depressive patients were randomly selected and divided in three groups as well. Group A, were treated with cognitive therapy; Group B, were treated with antidepressant medication and Group C, were treated with combined therapy (medication and cognitive therapy). Outcomes were assessed with the Beck Depression Inventory.Results: Outcome showed cognitive therapy, medication and combination Cognitive therapy intervention and medication had positive effect on depression therapy. There was no significant difference between medication and cognitive therapy, But significant differences between cognitive therapy and medication with combination method.Conclusion: Depression can be treated with medications, cognitive therapy, or both. Outcomes have showed that the combination of medications and cognitive therapy was more effective in our cases.

Introduction & Objective: The objective of this study was to determine the evaluation of intrathecal sufentanil for labor analgesia with respect to duration of labor stages and relief of pain during labor. Materials& Methods: In a clinical trial 60 subjects with ASA class I were selected and randomly divided in two equal groups. 30 subjects had received sufentanil 10 mgr in 1 ml of saline during active phase of first stage of labor. The other group as controls did not receive anything for analgesia. Parturient visual analog scale (VAS) , HR, RR, BP, sensory and motor block, FHR and complications such as nausea, vomiting, pruritus and duration of stage I been monitored recorded and compared among those two groups.Results: Comparison of results in two groups have showed that sufentanil does not prolong the duration of labor in stage 1 and 2. We observed lack of hypotension and respiratory depression in sufentanil group FHR changes that had been associated with adverse neonatal outcome had not occurred. The apgar scores in two groups were identical. There was itching in majority of parturient who had received sufentanil (83.3%). The pruritus was defined as mild and moderate.Conclusion: Intrathecal sufentanil provide a good analgesia in stage I labor and do not prolong the duration of labor with minimum adverse effects on parturient and fetus.

Introduction & Objective: Around 22% of pregnancies reach to 40 weeks or more. Investigations have shown that PG is effective in improving cervical ripe and shortening the labor. Stripping also is one of the effective approaches for reducing post date pregnancies. This study was undertaken to compare vaginal Misoprostol (PG E1) and membrane stripping to improve Bishop Score and shortening of labor in post date pregnancies.Materials & Methods: In this randomized clinical trial, 60 post date pregnant women (gestational age> 40w), primigravida and gravida 2 enrolled in two study groups. Group A was stripping and group B was PG E2 (Misoprostol) tablet. The mean of labor time and Bishop Score changes compared by t-student test.Results: Mean of labor time in the group B and A was 11.6±8.8 and 11.9±6.8 hours respectively. Mean of Bishop Score change in group A was 4±0.81 and in group B was 3.7±1.86. Conclusion: Efficacy of each method in improvement of Bishop Score and reduction of labor time was equal and statistically had no significant difference.

Introduction & Objective: There are different methods for detection of fetal growth restriction. The most important methods are serial fondle height (SFH), and ultrasonic measurement. The sensitivities and specifities of those methods are vary among different population, so, in a comparative study, we evaluated the sensitivity and specificity of SFH, a safe and simple method, and Doppler ultrasonography in F.G.R.Materials & Methods: This study was cross-sectional and we selected 550 pregnant women with growth retardation in physical exam more than 4cm in SFH. So they referred to Doppler ultrasonography. We matched their demographic characters, obstetrics history, B Mode sonography finding (AFI placental grading) and evaluated in last records of neonatal weight and other records for IUGR. We analyze sensitivity and specificity of SFH and Doppler ulterasonography in detection of IUGR.Results: The average age was 22.5±4.9 (16-45), average of Parity was 1.3±0.7 (1-11). Prevalence of IUGR in population study was 9.4% and sensitivity and specificity of SFH in detection of IUGR 44.7%, 93.8% respectively with positive predictive value 44.8% and negative predictive value 94.6%, Doppler ultrasonography sensitivity and specificity was 90.9% and 100%respectively.Conclusion: SFH in detection of IUGR is a valid measurement and drawing growth curve is necessary.

Introduction & objective: Despite of young and adolescence intent to the boxing sport, because of dominant aggression and direct blows contact to head, face and central nervous system, it is continuously criticize by different groups. The groups of sporting and physician conventions re distinguished boxing with physical and neuropsychological disorders and some groups believe that side effects of this sport are not more than other sports. For this base the aim of this study was to determine the chronic traumatic brain injury in group amateur boxers.Materials & Methods: In a case-control study, three groups of sport men were considered, each group contained 20 randomly selected cases. The first group were amateur boxers with 4 years minimal activity(directly has been presented to the head blows), second group were amateur soccer players with 4 years minimal activity(has been presented to the not very severe head blows), third group were non athlete subjects .The groups were matched in weight, height, age and education .To understand brain disorder interview by medicine method has been used, then Wiskancin, Bonardele, Bender geshtalt, Kim karad visual memory, Benton and Wechsler memory (Alef type) tests has been performed and EEG has got in the same hour and condition.Results: The homogeneity of between group variances was gained by the statistical method. Also between structural-visual abilities neuropsychological aspect in groups, significant difference has been gained (p= 0/000). In Kim karad visual memory test at the mild and long term visual memory deficit, significant differences between three groups was observed (P= 0.000, P=0.009) that least score has been belonged to the boxers. Also in boxers 6 abnormal EEGs is observed.Conclusion: It can be said that of four years amateur boxing can affect on boxers visual and memory perception and their spatial orientation. Additionally our study has showed that amateur boxing has a significant relation with traumatic brain injury.

Introduction & Objective: Now days a considerable progress in the production of instruments for canal preparation can be seen. Efficiency and resistance of files during canal preparation are very important. The aim of this study was to compare surface defects in Aryatec, Mailifer Stainless-Steel (ss) and Mailifer Nickle-Titanium (Ni-Ti) K-files before and after canal preparation.Materials & Methods: This experimental study was done on the 3 groups consist of aryatec and mailiferss K-files and Mailifer Ni-Ti K-file. In each group 30 files were selected. Each file pre and post instrumentation was observed for flextion, cracks, fracture, metal flashing, stretching, and partial clockwise using light stereomicroscope at a magnification of 40x. The data were analysed using X2 and ANOVA. Result: In all group no crack and partial clockwise were observed. Flexion in aryatec was more than the others (P<0.05). There is no significant differences, in metal flashing, fracture and stretching (P>0.05). 4 aryatec files had primary stretching and 1 mailifer Ni-Ti file were fractured after 5 times that differences were not significant(P>0.05).Conclusion: There are no significant differences between surfaces defects in aryatec, mailifer ss and mailifer Ni-Ti before and after canal preparation.

Introduction: Primary cardiac tumors are extremely rare in infants and children. Most primary cardiac tumors in pediatric age group are benign, and less than 10% of such tumors are malignant. Many of these tumors are asymptomatic and incidentally diagnosed. The clinical manifestations are very different and include direct cardiac effect, systemic effect, and embolic phenomena. Every infant or child with an unusual cardiac murmur, unexplained congestive heart failure, or arrhythmia should be evaluated for cardiac tumors. Echocardiography has contributed significantly to the evaluation of these patients. Surgery is the only treatment for primary cardiac tumors that require intervention with a relatively good Prognosis.Case Report: The patient was a 20 days old neonate presented with severe congestive heart failure. Evaluation of the patient showed primary cardiac tumor in the left atrium and ventricle. We recommended surgical removal of the tumor but her parents denied surgical intervention at all. Conclusion: After about one year follow up, congestive heart failure symptoms were controlled and the tumor size was decreased.

Introduction: Epidermodysplasia verruciformis (EV) is a very rare, chronic and inherited disorder characterized by widespread and persistent HPV infection. EV Patients present with widespread, discrete or confluent lesions that clinically indistinguishable from plane warts, scaly hyper or hypopigmented macules closely resemble pityriasis versicolor, and thicker plaques may resemble seborrbeic keratosis. Susceptibility to the virus is inherited, usually autosomal recessive. The disease usually manifests in childhood and continue throughout the life. The most important complication is cutaneous changes of dysplasia and malignancy. Case Report: We report a 19 years old boy with clinical and histopathological findings compatible with EV and coetaneous changes of dysplasia and malignancy. Conclusion: We concluded that in patients with combination of plane warts pityriasis versicolor-like lesions and reddish plaques, it may be considered EV, and it is recommended to evaluate coetaneous changes of dysplasia and malignancy.

Introduction: Polyarthritis, also called periarthritis nodosa (PAN) is a disease of small and medium-sized arthritis. In a subset of patient with PAN, however, the disease process remains localized within it single organ or a precise anatomical area.Case Report: A 29-year old man was referred to our department for the pain in the 2/3 upper of the external face of his left arm. The radiography was consistent with soft tissue swelling and periosteal reaction. MRI showed abnormal signal involving muscle in some parts. The surgical biopsy was done. Conclusion: Pathological study on the specimen supported the PAN (polyarthritis nodosa) so prednisolone 1 mg/kg was started and provided relief of pain and myalgia.