Avicenna Journal of Clinical Medicine
Year:2000 | Volume:7 | Issue:2 (SN 16)|Papers Count:13

This study was performed to determine and compare the onset time of epidural anesthesia between lidocaine - sufentanil and lidocaine - bicarbonate.Eighty - one patients aged 14 - 65 years who underwent surgical procedures under epidural anesthesia were studied in the Hamadan Medical Sciences University Hospitals in 1998. This study was a double blind,clinical trial.The patients were divided randomly to three groups (lidocain-plasebo, lidocaine-sufentanil and lidocaine-bicarbonate). After performing the method , the obtained information were entered into the questionnaires. Next , all data were analysed by using one way analysis of variance in the statistical software EPI6.The cold sensory time (sympathetic block)in both groups of lidocaine-bicabonate and lidocaine - sufentanil (5.11min.) was shorter than that of the controlled group(10.22 min.). Besides, the pin prick loss time (sensory block) in the lidocaine- bicarbonate (7.92 min.) and lidocaine- sufentanil (7.29min.) groups was shorter than the controlled group (11.88 min.). Duration of analgesia in the lidocaine - sufentanile’s group was more than the lidocaine - bicarbonate’s and lidocaine - placebo's group (350.3 min.versus 221.5 min.and 160.6 min.).The three groups didn’t differ significantly with respect to systolic, diastolic and mean arterial pressure and heart rate. Among the narcotic complications, the incidences of pruritus was 3.7%, but other complications such as nausea, vomiting and respiratory depression were not observed.Consequently, sufentanil can be used in epidural anesthesia, because it has fast onset of the anesthesia, prolonged duration of analgesia and low incidence of its complications.    

The present study was conducted to determine viability rate of protoscoleces and fertility rate of hydatid cysts isolated from 118 sheeps and 114 cattles slaughtered at Zanjan abattoir during 1998. At first , cyst number of the infected organs was counted and their diameter was measured. Then by dissecting the cysts , their fertility was determined. To determine protoscoleces viability , eosin - staining technique was applied. The results indicate, in infected sheep, cysts were found in 17% of the livers , 47.5% of the lungs and 35.5% of the livers and lungs concurrently, with cyst fertility rate of 49.15% and protoscoleces viability of 67%. In infected cattle cysts were found in 5.26% of the livers, 80.7% of the lungs and 14.04% of the livers and lungs concurrently , with protoscoleces viability of 58%. 96.5% of the cattle organs were found infected with mixed fertile and infertile cysts. Frequency of the multivesicular cyst in both liver and lung was higher than univesicular cyst. Fertility rate of liver cyst was higher than lung cyst and multivescular cyst higher than univesicular cyst. No significant difference between protoscolex viability rate of liver and lung as well as multivesicular and univesicular cysts were observed.  

Obesity status is unknown among Hamadan primary-school students. The main objective of this study is to determine its’ prevalence in the study population.This study was conducted on two thousand school children of Hamadan city, Iran. A sample of 2000 children aged 6 - 11 years was surveyed (1000 boys and 1000 girls). The weight (kg) was taken by a standardized weighting scale while height was measured using a Plastic-band. For diagnosis of obesity, NCHS (National Center for Health Statistics) standard method was used. The children's which were among the 90 & 95 percentiles were assigned as obese and those who were up the 95 percentile were considered as very obese. The results showed that 3.5% percent of children were obese and 2.55% were very obese. The prevalence of obesity was higher in females compared to males (7.2% VS 4%). The difference was statistically significant (P<0.01). The figures were compared to those of the United States of America and European countries. It can be concluded that obesity is not a major problem in the surveyed population, While, the percent of lean peoples (10.2%) in these cases was higher than the obese peoples.    

Among the neurologic diseases, C.V.A (Cerebro Vascular Accident) is the most prevalent cause of fatality, that makes also a great number of patients disable to do their daily activities. So we can reduce the mortality rate by knowing the risk factors. In this study we tried to find frequency rate of Ischemic C.V.A and its risk factors. In this study we used 386 patients' folders, the diagnosis was generally based on clinical symptoms and CT- scans in 1994-1995. The studied risk factors were: blood pressure, diabet , age , sex , hyperlipidemia, smoking and heart diseases. Analysis of the data showed that the most prevalent kind of C.V.A was Ischemic and the greatest risk factor was blood pressure. As the known risk factors of Ischemic C.V.A are the same kind that can be investigated and treated simply, so it is probable that we will be able to avoid occurring it, by controlling these factors.    

The skill and knowledge of doctors affect the in-hospital mortality. Recent documented studies in this regard are scant. In this study in-hospital mortality of patients at Ghaem children’s hospital - Hamadan for 6 consequent years (1989-1995) was investigated.In the first 3 - year (1st p) patients were firstly managed by the interns who worked under supervision of an in-hospital GP. In the second 3-year (2nd p) a full time residency was established in the hospital and the patients were firstly handled by the residents. In both periods an on-call service of the attending pediatricians was available. Number of admissions in 1st p and 2nd p were 5804 and 5663 respectively. Number of deaths in 1st p were 735 and in 2nd p 309. Number of deaths in the first day after admission in 1st p were 448 (7.6% of admissions) and in 2nd p125 (2.4% of admissions). Number of deaths after the 1st day of admission in 1 st p was 287and in 2nd p 184. Distribution of the patients by sex, age, causes of death, dwelling area, maternal education, weight for age, duration of admission was not considerably different in both periods. Number of the attending medical staff, nurses, and also the therapeutic and paramedical facilities were similar in both periods. Reduction in mortality rate was conspicuously more in the 1st day after admission and less in the neonatal period. Higher quality of medical services lowers hospital mortality.

In this retrospective cross sectional study the records of 6632 upper gastrointestinal endoscopy that were carried out between 1988-1997 in Mobasher Kashani general hospital endoscopic ward were analyzed.Majority of patients were from the out patient department and few of them were admited cases. 2278 cases (35%) were diagnosed as gastritis. 1165 cases (17.6%) normal, 911 patients (13%) as gastroduodenitis, 671 (10.5%) of bile reflux gastritis , 646 (9.5%) cases of active duodenal ulcer and duodenitis, chronic duodenal ulcer, gastric ulcer, carcinoma of stomach and gasrtic outlet obstruction as the rest. It was concluded that the gastric outlet obstruction was the least frequent cases of upper GI endoscopy [98 cases (1.4%)]. In this study profession, sex, age and clinical signs of patients were analyzed by EPI software package. In some cases comparison with similar studies was performed.    

The purpose of this study is to show the disagreement between the clinical and pathological diagnosis.The hospital records of 150 patients with clinical diagnosis of acute appendicitis have been studied to find out the histopathological criterion, and 104 cases confirmed by histopathology study.Eighty four patients (56%) were male and 66 were female (44%). The majority of them were in 15-24 ages group. The most accurate diagnosis was in male group (81%) and in female it was 54.5%. The most accurate diagnosis was in 25 - 34 years ages group and the lowest was in 35-54 years ages group. Highly competent, 2 surgeons make positive diagnosis of acute appendicitis and removed appendix with acute inflammation, that the accuracy of diagnosis was about 79%. The lowest accuracy of diagnosis was about 47%.I conclude that disagreement between surgeons and pathologists was happened in 26.6% of cases.    

Through four years period of time (from 1994 to 1998), 116 renal transplants performed in Ekbatan Hospital. In the period, all transplants selected from living donors. In our cases, one year graft survival was 96.5%. In the period of the study 95.6% of grafts were functioning. Majority of complications were infectious, numerically 23%. In the study group the mortality rate from grafts of men to women was 2%. For men to men was 6.7%and there was no death for graft of women to women and to men. Average age of recipients was 37 and for donor it was 34 years. The best results of transplantation obtained from donor who was in the age group of 20 - 30 years old that took place without complication of renal failure o r death. In this study five patients died. The causes of death were as follow: one patient from lip carcinoma, one patient due to pneumonia, the third patient from encephalopathy, forth patient from pulmonary failure and finally one patient from diabetes complication.    

Direct examination of the tracheobronchial tree with flexible fiberoptic bronchoscopy has greatly facilitated the diagnosis , staging and management of pulmonary neoplasms and other lung diseases. The purpose of this brief review is assessed to see the indication and rate of diagnosis of this procedure in a regional center such as Hamadan. Fiberoptic bronchoscopy survey in 300 patients in a two year study by author showed that its most important indication in 261 cases (87%) was for the diagnosis of bronchogenic carcinoma and 210 cases of them (85%) showed abnormal changes in the bronchi. Malignancy was proved in 183 cases by pathologic investigations. The commonest radiologic finding which could reveal of abnormal bronchoscopy view was collapse atelectasis and central opacity followed by RUL involvment.Recently with using brushing biopsy and providing cell block, some experiments are being brought into existence in Hamadan. Complication with this procedure is very rare and concerning the efficiency of this procedure in out patients with local anesthesia and the least preparation has plain preference to rigid bronchoscope.

This report describes a rare case of uterine cervical stromal sarcoma in a virgin 22 years old girl before sexual experience. She admitted for recurrent pyelonephritis and pelvic mass (vaginal origin). Pathologic exam revealed myoma with low mitosis. The mass recurred after a year and the pathological diagnosis was low grade spindle cell sarcoma. Immunohistochemical staining showed stromal sarcoma. Hysterectomy was carried out. In a 30 months follow up after the primary diagnosis, the patient showed recurrence of pelvic symptoms.