Researcher Bulletin of Medical Sciences
Year:2005 | Volume:9 | Issue:5 (41)|Papers Count:13

Background: There is no evidence supporting the routine lab tests, However, they are performed on most hospitalized patients to Obtain their current basic clinical values. Due to increasing Knowledge about cost efficiency of healthcare measures, many researches are aiming at reducing routine lab tests performs.This research was performed on patients of interval medicine word of Bu Ali hospital in 1383, to assess the performance of physicians regarding Diagnosis, treatment and care provided based on clinical data Obtained by routine lab tests.Materials and methods: The data was gathered by studying 438 clinical documents the documents were categorized and analyzed in three groups after clarifying primary and secondary diagnoses. Performance A: Normal range lab values.Performance B: Normal range values resulting the repetition of the lab tests but not influencing primary diagnosis or care of the patients. Performance C: abnormal values resulting in change in primary diagnosis or type of care provided.Results: the results showed that in 10% of cases the lab tests were repeated and in 5% the lab test results have caused a change in diagnosis or care type provided.Conclusion: The results showed that when selecting the lab tests for those who are supposed to be hospitalized, the patient should first be thoroughly assessed and then some lab test should be chosen according to the doctors clinical point of view to determine the cause and / or severity of the illness to avoid further avoidable costs while maintain the logical paints aimed by the doctor.Finally, it is recommended to routinely perform the fasting blood sugar measurements, renal function tests, Hemograms while it is decided to hospitalize a patient since they affect the doctors vision regarding a patient.

Background: Smoking is the first reason of preventable death in the world, Since the family has an essential role in forming the character of teenagers, evaluating the relationship between cigarette consumption of family members and teenagers smoking is very important.Materials and methods: For this purpose a study was designed based on WHO and GYST smoking which 1095 high school students were randomly selected from different areas of Tehran city in the years 2002 and 2003. Results: Results of this study showed that 28.9% of students (25.5% male and 30.8% female) were occasional smokers (p=0.07) and 4.4% of students (6.01% male and 1.6% female) were daily smokers (p=0.001). 23.6% of students whose family members did net smoke were occasional smokers, while this incident reached 53.4% in those who had one or more smoking family members (p=0.0001).The frequency of daily smoking among the student was 2.6% and 14.3%respectively (p<0.0001).27.3% of students who lived with both parents smoked occasionally but in students who lived one of their parents it increased to 52.4% (p<0.0001).Conclusion: The results of regression analysis showed that training and encouraging family members in regard to smoking cessation and also having a stable family environment are very important factors to prevent from the start and continuation of smoking in teenagers.

Background: Connecting the chest bottle system to suction apparatus is a common practice after thoracotomies. The loud and unpleasant sound of air bubbling in the chest bottle while connecting to suction, might be troublesome to the patient and others. This problem has not been considered appropriately until now.In our study we tried to solve it by making a simple device and connecting it to the chest bottle.Materials and methods: By connecting two little sized funnels using tapes, we made a device which can be connected to chest bottle and acts like a muffler and decrease the sound of bubbling caused by suctionin. Results: The device was used in 10 patients, and their satisfaction following its use was increased due to the considerable suctioning sound decrease.Conclusion: This reduction of sound was sendible to both the patients and examiners.This simple easily accessible and cheap device can effectively reduce the sound of chest bottle suctioning.

Background: Non-communicable diseases (NCDs) and their risk factors are highly prevalent in Iran; thus there is an urgent need for nutrition interventional programs to curtail these risk factors. This study was aimed to assess knowledge, attitudes and practice of urban Tehranians regarding nutrition and in relation to non-communicable diseases.Materials and methods: This cross-sectional study, conducted within the framework of the second phase of Tehran Lipid and Glucose Study (TLGS). From 15005participants in TLGS, 826 subjects (457 women and 369 men), aged 20- 70 years old were randomly selected. Their knowledge, attitudes and practice were assessed by a questionnaire, the validity and reliability of which were determined and authenticated by focus groups and an expert panel. Height and weight were measured and body mass index (BMI) was calculated. Biochemical data including serum cholesterol, triglycerides and HDL cholesterol were measured according to standard protocols and LDL concentration was calculated. For determining the correlation of knowledge, attitudes and practice with sex, age and educational level, Chi-square test was used.Results: Of the studied population, 26.5, 52.7 and 20.8% had desirable, moderate and weak knowledge scores, respectively. For attitude, 27.6, 48.9 and 23.5% had desirable, moderate and weak score, respectively. Regarding practices the percentages for this group were 27.4, 51.7 and 20.9%, respectively. Those with middle school degree or university graduates had higher knowledge scores than illiterate and low literate ones (p<0.001). On the other hand, illiterate and low literate groups had higher practice score as compared to middle school and high school graduates (p<0.001). Mean practice scores of university graduates were higher than high school graduates (p<0.05). Married individuals had more desirable practices than singles (p<0.001).The difference disappeared after adjusting for age. Those aged 30-50 year old had higher knowledge scores than older ones (p<0.001). With increase in LDL cholesterol or total cholesterol level, people had more desirable practices (p<0.001). Subjects with borderline triglycerides level had better practice scores than normal individuals (p<0.001). Based on BMI, obese individuals had more desirable nutritional practices as compared to overweight and normal ones (p<0.001).Conclusion: The findings revealed that age, educational level, gender and matenal status are factors that can influence nutritional knowledge, attitude, and practice. It is vital to implement programs using different ways to promote the nutritional practices of the population.

Background: Autoimmune hepatitis is an autoimmune chronic inflammation of the liver with unknown cause.CD45 is a membrane PTPase, which is required for the intiation of T and B cell signaling events. CD45RA and CD45RO are members of CD45 family, which are expressed on the naive T lymphocytes and primed population of memory T lymphocytes respectively. Recently abnormal CD45 splicing, caused by a C77G mutation in exon 4 (exon A) of the gene encoding CD45 was associated with the development autoimmune hepatitis. So we investigated the frequency of this mutation in Iranian patients with autoimmune hepatitis and controls.Materials and methods: in this study we investigated the frequency of this mutation in a case-control study between 70 patients with AIH (49 female, 21 male) and 140 healthy blood donors (89 female, 51 male) matched by sex and age. Extracted genomic DNA was amplified by MspI restriction enzyme.Results: Mean age±SD of cases and controls were 35.3±11.5 and 35.3±14.5 respectively. None of the cases was hetero or homozygote for this mutation; however one of the controls was heterozygote for C77G mutation.Conclusion: We conclude that there is no association between C77G polymorphism and AIH at least in Iranian patients; however, there is no data on the frequency of this polymorphism in our population. It appears that either polymorphism is a rather new one or the founder population for this polymorphism restricted to Caucasian to Germany.

Background: Functional endoscopic sinus surgery (FESS) which created revolution in treatment of chronic sinusitis is dependent in two factors: 1- understanding the role of osteomeatal complex in sinusitis. 2-development of optic endoscopy new optic equipments caused endoscopic sinus surgery change to usual approach of the treatment in chronic sinusitis which hasn't respond to medical treatment. Because usefulness and effectiveness of this method and using of this method routinely in recent years in IRAN, this research has occurred from 1375-1381.Materials and methods: in this descriptive research, 327 patients who have chronic sinusitis and haven't respond to 6 week medical treatment, and followed with endoscopic treatment, have studied.Results of treatment based on subsiding of symptoms (subjective) and complications of surgery have recorded. All of the patients have followed for 4 months after surgery.Results: This research showed that 6 percent of patients cured completely, 78 percent cured partially, and 16 percent didn't change their signs and symptoms. In other hand, based on the results of this research, 84.4 percent of patients had been absorbed, 15 present adhesiveness and 3 percent subcutaneous emphysema only in one present of patients major complication (CSF leak) occurred.Conclusions: Related to increasing use of Endoscopic sinus surge-y in IRAN, especially in recent years and relating to effectiveness of this method, for prophylaxis of invasive and destructive sinus surgery and decrease of complications, it is better this method has been done by specialists that have been taught good.

Background: Type 2 diabetes mellitus may represent a disease of the innate immune system responsible for an ongoing cytokine-mediated acute phase response and fish oil may suppress inflammatory mediator. The ability of omega-3 fatty acids from fish oil to suppress inflammatory mediators and and its consequent effect on glycemia, serum lipids, blood pressure and insulin sensivity was studied in a clinical trial on patients with type 2 diabetes mellitus.Materials and methods: A total of 26 (10 male and 16 female) were given 3000 mg omega-3 fatty acids, daily, for 8 weeks. The serum level of inflammatory determinates and biochemical ultrasensors were measured by kits, and aquestionnair based on body measurement (anthropometric indexes), medical data was completed. Results: All 26 cases (10 male, 16 female) full filled the study. mean age, acquiring DM, body mass index were 52.7 9.2 years (1SD), 9 6.0 years, and 27.32 2.9 years respectively. The results of this study showed there were no significant differences in fasting blood glucose and insulin at baseline, week 4 and week 8 after supplementation despite a significant decrease in serum sialic acid triglycerides, cholesterol and blood pressure were decreased.Conclusion: A moderate dose of omega-3 fatty acids did not lead to deleterious effects on glycemia control in patients with type 2 diabetes mellitus, with preserved beneficial capacities.

Background: Diet bread imparts an important role in human nutrition and is consumed widely in Tehran. Diet breads distributed in Tehran do not enjoy best quality regarding nutritional criteria. Hence this study was undertaken to evaluate the quality value. In order to investigate the quality, the study was conducted on 18 randomized barley pan breads, 7 crispy flat barley breads and 5, crispyflat oat breads.Materials and methods: This research was designed in two stages the first stage was descriptive 18 breads claimed to be diet were randomly collected from the market including barely pan breads,7 crispy flat barely breads, and 5 crispy flat oat breads. Chemical characteristic of breads i.e. moisture, ash, pH, carbohydrate, fat, protein, fiber and phytic acid were determined based on AACC , AOAC and Thompson and Erdman methods. Oat bread was also baked using Avena Sativa variety and its chemical characteristics were measured and compared with samples. The results were analyzed by T-test.Results: Regarding the phytic acid, the amounts based on dry basis were as follows: oat pan bread 275±2.1mg/100g, barley pan bread 359.5±61mg/100g, crispy barley flat bread 437±92.8 mg /100g, crispy barley flat oat bread 622.6±127.4 mg/100g. Fibers in oat pan bread was 2.29±0.02 g / 100gon dry basis while in pan oat bread samples from Tehran market was 0.99±0.47 g /100g.Conclusion: Nutritional value of marketed breads was very poor in compare with actual oat bread baked in the laboratory and regarding the importance of diet bread we suggest proper supervision on production.

Background: Posterior urethral valve is one of the important pediatric obstructive lesions, and also a cause for end stage renal disease. Some previous researches which aimed at identifying factors related with renal survival have resulted in controversial findings.Materials and methods: In this research, renal survival and related factors was studied in these patients. 59 patients with posterior urethral valve in two groups with and without end stage renal disease were studied.Results: This research was performed on 59 patients suffering posterior urethral valve the Mean renal survival was 127.8 months, and the slope of renal failure progression curve was descending. Lower weight, creatinine at admission, serum potassium more than 5 meq/L, BUN more than 35 mg/dl, type of surgery (the least for urethrostomy and most for vesicostomy), and the creatinine at admission were related factors with renal survival, but height, patients age at which diagnosis was made the history of urinary tract infection, age at which the patient underwent surgery of surgery were not important on renal survival.

Background: With respect to the importance of STDs, this descriptive study was conducted to diagnose contamination and determine effective factors on contamination of trichomonas vaginalis and gonorrhea in female prisoners at Evin Jail.Materials and methods: 151 subjects with at least one record of marriage were selected. Data collection tools included a questionnaire, a checklist, and laboratory equipment including microscope, incubator, autoclave, fore, culture media, and digital scale. Content validity was used to validate the questionnaire and checklist. The equipment was calibrated and set by medical engineers.Sample from vaginal secretions were taken to diagnose the microorganisms. To observe trichomonas vaginalis, slides were prepared for gonorrhea; then the samples were cultured and put in slides with appropriate staining.Results: Mean age of the subjects was 32.08 and their mean age of marriage was 16.9. %31.1 were illiterate, %70.9 were housewife, and %29.1 were employed.%26.5 were contaminated by trichomonas vaginalis but no gonorrheal infection was detected. Factors such as job, itching, burning, and redness of vulva; vaginal secretions and its foul smell; vaginal redness; and frequency had a significant relation with contamination rate of richomonas vaginalis. Conclusion: The results showed that those who did not apply health principles were susceptible to contamination of the disorders. In spite of having medical facilities, the contamination rate of the subjects was relatively high. It can be concluded that the necessity of obligatory medical examination, management, and follow-up in this population has a critical importance.