Researcher Bulletin of Medical Sciences
Year:2008 | Volume:13 | Issue:3 (63)|Papers Count:18

Background: Respecting the incidence of hot flashes in postmenopausal women and its effect on their socioeconomic lives and the controversies regarding its treatment, this double-blind clinical trial was conducted to determine the effects of Anise abstract on hot flashes in these women referring to rural and urban health centers of Qazvin province during 2006.Materials and Methods: 72 postmenopausal women with hot flashes at different severities were randomly selected according to pre-determined criteria and divided into two groups of experimental and control. Their medical records at health centers were used for sampling. Each woman in the experimental group took a capsule containing 100 mg Anise 3 times a day while, in the control group, women took 3 placebo capsules, each containing 330 mg starch. They took the capsules over 4 weeks. Before taking the capsules, they were assessed for a week about the frequency of hot flashes and the types of food they took. Data were collected by a questionnaire and an information form. Content and test-retest methods were used for validity and reliability of the tools. ANOVA and t-student test were applied for statistical analysis.Results: Demographic information of the subjects included: mean age=51.63, amenorrhea duration=2.39, body mass index=27.13, number of pregnancies=6.56, percentage of the married=95.8 and percentage of primary education=37.7. 80.6% of hot flashes occurred at nights. In the experimental group, the frequency and severity of hot flashes before treatment were 4.21% and 56.21% and, after that, were 1.06% and 14.44% at the end of the fourth week, respectively. There was no significant change in the frequency and severity of hot flashes in the control group.Conclusion: Anise is effective on the frequency and severity of hot flashes in postmenopausal women. These women can be taught to choose different alleviating methods, preferably. Further studies with longer duration of treatment for assessing hot flashes are warranted.

Background: Increased Endothelin I (ETI) activity may contribute to the complications of, cirrhosis and portal hypertension. The main aim of this study was to determine the role of Endothelin I in cirrhotic patient with portal hypertention and hepatopulmonary syndrome.Materials and Methods: Fifty patients with biopsy proven cirrhosis and 50 normal healthy controls were selected for study. After getting informed consent, two dimensional echocardiography, chest x-ray and pulmonary function test have been done for all cirrhotic patients; Patients with cardiac and pulmonary disease history were excluded from the study and the cirrhotic patients who had proved to have intra-pulmonary vascular dilatation in their contrast echocardiogram were classified as the positive HPS.Results: A total of 100 subject (60 males and 40 females in both case and control group) enrolled in the study. Among cirrhotic patients, 10 subjects with clinical and 7 subjects with sub clinical HPS were detected. The most common etiology of cirrhosis was HBV.Hepatopulmonary syndrome was significantly higher in class C (P=0.007). There was no significant difference between plasma Et I level in both clinical and subclinical HPS compared to other cirrhotic patients. ET I levels in cirrhotic patients (2.29 pg/ml) were significantly higher in cirrhotic patients compared to that of normal healthy controls (0.85 pg/ml) (P = 0.038).Conclusion: The effects of HPS on cirrhotic patient’s survival are unclear. As to other studies, we found significant increase in plasma Et I level in cirrhotic patients rather that normal subjects, but in contrast to previous study we found no relation between Et I level and HPS. Only further studies with further numbers of cirrhosis-caused HPS patients may bridge up the gap between scientific effort and credibility in this field.

Background: This study has been conducted to determine the effect of using oral rinse benzydamine in prevention of radiation induced mucositis.Materials and Methods: Patients with head and neck cancers, who referred to Cancer Institute between 2004 and 2005, were enrolled in a double blind clinical trail. They had to receive 15 cc of oral rinse benzydamine or placebo, four times a day, from the first day of radiotherapy up to the end of the course. The incidence of mucositis grade 3 or more was evaluated.Results: From 100 patients who were randomized in this trail, 19patients were excluded of the analysis due to minor side-effects of drug, or stopping the radiotherapy. The incidence of mucositis grade 3 or more was 43.6% among 39 cases in treated group, whereas among 42 cases in placebo group this rate was 78.6 %. The difference was, therefore, significant (P< 0.005). Mucositis grade 3 or more was 1.8 times more frequent in placebo group (Relative Risk=I.8). Also, if the patients did not receive benzydamine the attributive risk of mucositis was 35%. After the third week of treatment, the mean grade of mucositis was more than 2 in the placebo group; but in the benzydamine group it was less than 2 up to the end of radiotherapy (P<0.001).Conclusion: According to these results it seems that oral rinse benzydamineis effective, safe, and well-tolerated for prophylactic treatment of radiation-induced oral mucositis in head and neck tumors. There is a need to evaluate the efficacy of benzydaminein another large study in Iran.

Background: Bacterial vaginosis (BV) is one of most prevalent complications among fertile women. Metromidazole prescription which is considered the first choice remedy for BV is usually followed by few side-effects. Besides, there is a growing tendency toward herbal medicines for treatment of vaginitis. Antibacterial and antifugal effects of Zataria multiflora have been demonstrated through in-vitro and in-vivo. This study aimed to compare therapeutic effects of Zataria Multiflora vaginal cream and Metronidazole vaginal cream on bacterial vaginosis.Materials and Methods: This was a randomized clinical trial on 90 married women aged 18-40, affected by bacterial vaginosis who attended for treatment to gynecology clinic of "Shabih-Khani hospital". They randomly divided into two groups each consisted 45 participants. Diagnostic criteria were Amsel's criteria and gram-stain. Zataria Multiflora vaginal cream or Metronidazole vaginal gel was prescribed for a five-night period for each group. After 2 to 7 days of administration, therapeutic effects, complications and the Amsel criteria were reassessed. Data analysis was performed by McNemar test to compare both the complications, Amsel's criteria and gram-stain in each group in their before and after treatment course. Fisher exact test was applied to comparethe therapeutic effects between two groups. Results: Complication and the Amsel criteria significantly decreased after treating by Zataria Multiflora vaginal cream or Metronidazole vaginal gel (P<0.05). Relative risk for unresponsiveness treatment with Zataria Multiflora, to Metronidazole treatment was 1.5 (CI 95%: 0.27-8.27) which was not significant andboth had therefore, similar therapeutic effects on VB.Conclusion: Zataria Multiflora vaginal cream has similar therapeutic effects to Metronidazole vaginal gel on VB. Thus, it could be an appropriate choice for VB treatment for those interested in herbal medicines or affected by side-effects of Metronidazole.

Background: The accuracy of the pre-hospital care has not been evaluated in Iran so that the purpose of the present study was to evaluate the efficacy of the pre-hospital care performed by Tehran Emergency Service in traumatic patients referred to "Sina Hospital".Materials and Methods: This prospective study was conducted on traumatic patients referred to emergency department of "Sina hospital" by Tehran Emergency Service from September 2003 to Septeinber 2004. The accuracy of the pre-hospital care performed by Tehran Emergency technicians, regarding the patients' general condition was evaluated. The on-call physicians in emergency department of "Sina hospital" were responsible for gathering the data and filling the questionnaires based on their observation and the EMS forms. Results: 994 patients were enrolled in the study. Wound bandage and homeostasis were done correctly in 80% of the cases. Splint was applied correctly in 50% of the patients, while other therapeutic procedures such as collar and spinal bed were not performed among 80% of the cases. IV-line was obtained in 91.2% of the patients, while serum infusion was initiated in only 20% of patients.Conclusion: It is recommended to compile evidence-based protocols for the pre-hospital procedures and train the emergency technicians to follow the rules, in order to improve the efficacy and the accuracy of the pre-hospital care. According to the principal changes recently made in the quality and quantity of the care offered by Iran's Emergency Service, it is necessary to perform a new study to evaluate the present condition and compare the results of these ,qualitative and quantitative changes with the current study.

Background: Saffron, the world's most expensive condiment, is one of Iran's most important non-petroleum exports. The drying method is determinant of saffron quality and price in the world market. So, the aim of this study was the comparison of the effects of satff on dehydration methods, like vacuum oven, freeze, microwave and solar drying with traditional method.Materials and Methods: During this experimental study and for production of saffron flowers, one of the farms in Gonabad was selected randomly and the flowers were picked and mixed thoroughly, together. The morphological specifications, percentage of yield of the stigmas, chemical test (moisture, ash, total nitrogen &, acid insoluble ash) were determined. Stigmas were dried. After dehydration the moisture content, total ash, acid insoluble ash, water soluble extract, total nitrogen, crude fiber, crocin, picrocrocin, saffranal and sensory specifications (color, texture and odor) were determined.Results: The results of chemical analysis indicated that the solar dried, vacuum oven dried and microwave dried samples had preferable color (crocine) outcomes. However, from aromatic point of view (saffranal) traditional sample had significant preference (P<0.05). The amount of the picrocroc in (taste compounds) in samples did not have significant differences within each other.The results of sensory analysis indicated that, color of dried samples by solar, freeze and microwave methods, soluble color of dried samples by solar, freeze and vacuum oven had significant differences (P<0.05) that other methods. The results of the microbiological test of all dried samples were in Iranian standard levels except the traditional and freeze dried samples. Conclusion: Although the samples of four methods of drying were of high quality compared to the traditional samples, the solar drying method can be reasonably applied in rural area as suggested method of drying.

Background: Purpose: There are several studies which have shown that adenotonsillar hypertrophy can cause airway obstruction, chronic alveolar hypoventilation and even may lead to severe cardiopulmonary complications like pulmonary artery hypertension. The aim of this study was to evaluate the effects of adenotonsillectomy on pulmonary arterial pressure in children with hypertrophic tonsils and adenoids.Materials and Methods: fourty children (21 males, 19 females) aged between 4 and 14 (mean 7/9±2/3) years with a diagnosis of upper airway obstruction due to hypetrophied tonsils and adenoids were included in our study. Pulmonary arterial pressure was measured by Doppler echocardiography both preoperatively, and 6 weeks after operation.Results: Preoperative pulmonary arterial pressure (PAP) was 26/1±3/9 mmHg and postoperative PAP was 25/9±5 mmHg. Although in two cases out of three ones who had raised preoperative PAP, adenotonsillectomy resulted in decreasing the, pressure, but there was no statistically significant difference between pre-operative and post-operative echocardiographic findings.Conclusion: It seems that whilst increasing of pulmomary arterial pressure (owing to Adenotousillar hypertrophy), adenotonsillectomy can be of beneficial outcomes in decreasing this pressure.

Background: Cervical cancer is the second leading cancer among women, worldwide. It is also the second malignant cause of death, particularly in women aged 25-65. In order to progress a cancer from dysplasia to invasive carcinoma, a cascade of cellular changes should occur. Since genital HPV carries oncogenes responsible for these essential changes, today HPV is consideredas the major risk factor of cervical cancer. It is believed that HPV can increase the rate of cancer progression when associating with other risk factors such as smoking, taking contraceptive drugs, immunosuppression, etc.Materials and Methods: paraffin-embedded cervical tissues of 70 patients with cervical cancer were analyzed by PCR method for presence of HPV. In addition, high risk typing of HPV positive samples was performed using HPV high risk typing PCR kit.Results: Among all patients 49% were positive for HPV. HPV16 was the most common type detected in HPV-positive cases. Investigation of age classification showed that a majority of HPV positive cases aged between 35 and 44 years.Conclusion: Considering the prevalence of HPV among young women with cervical cancer and its long premalignant period, we suggest to examine all the women above 20 years of age and also check the suspected cases for HPV.

Background: In view of the high morbidity and mortality of patients with congestive heart failure, early diagnosis is of paramount importance. To assess the diagnostic and prognostic utility of plasma levels of the NT-Pro BNP in patients presenting with heart failure this study was carried out.Materials and Methods: This cross-sectional study was performed on patients with heart failure admitted in the cardiology ward of Taleghani Medical Center during a certain period from 2005- 2006. Subjects with acute coronary syndrome, hyperthyroidism, renal failure (GFR< 60), severe valvular stenosis, severe pulmonary disease, ARDS, hepatic cirrhosis, primary hyperaldosteronism and the candidates for heart transplant were excluded from the study. Blood samples were collected and plasma levels of NT-Pro BNP were measured by ELISA method (Biomedica- crop, Bratislava Slovakia). Results were documented and analyzed using SPSS software. Mann- Whitheny and KrusKall-Wallis tests were utilized for analysis. Values were analyzed for confounding variables (e.g age, sex, blood pressure, and ischemic heart disease and NYHA class). Results: 79 patients full filled the criteria of inclusion. 70% were males and mean age of patients was 63 ±14 years. Mean plasma NT-Pro BNP level was 421±387. In subjects < 60 years of age, the mean levels were 309±300, and among those ³60 years it was 486±419, (P< 0.05). With advancing clinical stage, the mean plasma level of NT-Pro BNP increased 6 folds, (p<0.01), whereas with advancing NYHA class it increased 4 folds (P< 0.01).Conclusion: It seems that plasma NT-Pro BNP level is a suitable indicators of the severity of heart failure.

Background: Acute diarrhea is one of the leading causes of worldwide mortality and morbidity; four millions annual deaths. The aim of this study is to investigate the prevalence of rotavirus and adenovirus among children with acute diarrhea and to evaluate their clinical and laboratory findings.Materials and Methods: 199 children aged 1 to 168 months with acute diarrhea were studied in "Mofid" Children Hospital for a one year period. Clinical and laboratory findings including stool culture and WBC and RBC counts in their stool samples were analyzed.Results: From 199 children with diarrhea, 14 cases (7%) were positive for viruses; 11 (5.5%) rotaviruses and 3(1.5%) adenoviruses. In Rotavirus and adenovirus, male to female ratio were 1.2/1 and 2/1, and the mean age were 40.8 and 2004months, respectively. Clinical findings comprised frequency, dehydration, fever, vomiting and watery diarrhea. Stool culture was negative and no RBC and WBC were detected. Conclusion: High prevalence of rotavirus and adenovirus in former studies and low prevalence of rotavirus in this study seems to be caused by the diagnostic method we used. Since a fast laboratory process is necessary for immunochromatography, other methods as EIA and PCR are recommended.

Background: Tissue expansion is widely accepted as a valuable adjunct for the reconstruction of the forehead lesions. Previous studies often have used the largest possible expander for forehead reconstruction which was often over expanded. In this article, we describe our experience for reconstruction of the pure forehead lesions covering 25-70% of the forehead surface with small size tissue expanders and advancement flap.Materials and Methods: 9 patients (mean age 27 years; range 8-47 years) who had pure forehead lesion covering 25-70% of their forehead surface were selected. Rectangular expanders (30cc) were placed subcutaneously in 3 patient and sub muscularly in 6 patient, respectively. Two weeks after insertion of tissue expanders, expanders were filled with 45 to 60cc of normal saline during a 5 week period. Advancement flap of forehead were used for all patient.Results: The aesthetic outcome was assessed by looking at symmetry, hairline brow position and scar appearance. All the after-expansion forehead reconstructions were considered successful. There was no complication such as infection, hematoma, and exposure and flap necrosis. Conclusion: Findings of this study suggest that applying small size tissue expanders and advancement flap for reconstruction of pure forehead lesions (with different size and cause) not only have desirable aesthetic consequences, but also reduce the complications and increase the patients' compliance.

Background: Patient's satisfaction is one of the most important health indicators in health care system which is used for care qualification and providing health services. Hence, a descriptive correlative study is carried out to determine the satisfaction degree of normal delivery and its relative factors in childbearing women at "Shaheed Charnran, Borujerd" and "Madiye, Tehran" Hospitals in 1385.Materials and Methods: In this study, 360 literate Iranian childbearing mothers were chosen via a non-probable quarto sampling. Data gathered by a questionnaire consisting of 4 parts (pain severity, personal control, environmental satisfaction, childbirth satisfaction) and two checklists of demographic features and past obststric records. Respectively, the pain ruler was used to estimate the pain severity, the questionnaire of labors Agentry Scale to personal control, 17-question Likert scale to environmental contentment and 18 questions derived from 34-item questionnaire of Mackey Childbirth satisfaction to childbirth content. Using SPSS 13, Mann-Whitney and Cruskal- Wallis non-parametric tests, Spearman's Correlation coefficlency, one-way Anova (variance Analysis) and regression test were applied to analyze the information.Results: Among the studied women, 72/2% were contented with their childbirth, whereas 8.4% of them were unsatisfied with their childbirth. There was a meaning full relationship among pain severity, environmental satisfaction, personal control, childbirth factor, reserved length of the first phase of labor, pregnancy age, the conformity of newborn's gender with father's and with mother's will (P<01001), lack of problem in their second and third delivery (P=0101),mother's degree of education (P=01009), economical situation (P=0102), and spouse's occupation (P=0103) with childbirth gratification in "Shaheed Chamran" hospital. There was a significant relationship between pain severity, personal control, the reserved length of the first and second phase(P<0/001) in "Mahdiye" hospital. Basedon regression test, the personal control variables (P<0/001) and environmental content (P=01005) were achieved to be the predictors of childbirth gratification.Conclusion: It is outstanding that the contentment with childbirth is a multi-dimensional issue and in order to increase the mothers' positive experiences and prevent them from side-effects of their negative experiences, all the aspects must be comprehensively, simultaneously, considered.