Researcher Bulletin of Medical Sciences
Year:2001 | Volume:6 | Issue:4 (24)|Papers Count:28

Background: Patients suffering from chronic pulmonary diseases are more prone to developing steroid-induced myopathy. Regarding the present controversies, we have studied the prevalence of myopathy and electromyographic findings among these patients being received steroid. Materials and methods: 72 patients with definite diagnosis of chronic pulmonary diseases being received corticosteroid drugs constantly for at least two months had entered this descriptive study. They were evaluated in four stages: 1) evaluation of history and clinical presentation, 2) physical examination of sensory-motor system, 3) electromyography in three conditions: at rest, minimal contraction, and maximal contraction, and 4) biochemical test including TFT, muscle enzymes and serum electrolytes. T -test and chi-square were used to evaluate results. Patients suffering from clinical weakness as well as EMG findings of myopathy disorder were considered as cases with steroid-induced myopathy. Disease prevalence and the relationship between the role of disease duration, dosage, and the age with the incidence of myopathy were all determined. Results: 72 patients taking averagely 10.5±2.5 mg/d corticosteroid for 47.3±10 months were studied.41 patients (56%) had complained of muscle weakness, where 68% of them had revealed to have clinical weakness by manual muscle testing. (39% of all cases) In 23 patients myopathy was confirmed by electromyography findings whereas biochemical tests were normal. No relationship was seen between daily dosage of drug, type of pulmonary disease, gender and myopathy. Although patients with myopathy had taken drugs for longer periods and were older than the others, the differences were not statistically significant. Conclusion: Long-term corticosteroid usage even in low dose could produce myopathy. Incidence of steroid-induced myopathy is significantly higher among patients with chronic pulmonary disease and since most of these cases have clinically apparent weakness, complaint of muscle weakness must been observed more seriously. EMG is a useful method in determining mild to moderate steroid-induced myopathy.

Background: Regarding the importance of educational quality promotion and improving educational program, the present study was conducted in Shahid Beheshti University of Medical Sciences, in the academic year 1998-99. Materials and methods: 384 students taking basic science courses had entered this descriptive study. Evaluation was achieved by asking students and professors about the usefulness of educational programs and determined facilities. Meanwhile, employing practical aspects of active learning technique was assessed by direct observation. Indices of the usefulness of educational programs and determined facilities for active learning technique was evaluated in four categories (very high, high, moderate, and low) and then recorded. "Very high and high" responses were considered as "useful intervention" and "low and moderate" responses were considered as "unuseful intervention". Those professors who have got 2/3 scores of performance (very high), were considered as successful performance of active learning technique. Results: 384 students, including 188 males (49%) and 196 females (51 %) with mean age of 20.1±1.6 yrs and 34 professors, including 18 (51 %) male and 16 (49%) females with mean age of 46.7±8.9 yrs had entered this study.135 (35%) of the students have stated that the active learning technique is useful and 32% have believed that determined facilities were enough. Considering the professors' opinion, these figures were 85.2% and 70.6%, respectively. Techniques of active learning were successfully achieved in 70% of the professors. Conclusion: Considering professors" opinion, active learning technique was employed successfully, but students have thought differently. So an action research is highly recommended to promote and improve educational programs.

Background: Considering the great importance of iron deficiency, anemia, and iron deficiency anemia as one of the most important indices of public health, the present study was carried out over the high school students in Varamin in 1998-99 to determine the prevalence of iron deficiency, anemia and iron deficiency anemia. Materials and methods: 799 students, including 466 females and 333 males had been randomly selected for this descriptive study. Then, demographic data were collected and HGB, HCT, MCV, MCH, MCHC, ferritin, iron and TIBC were all measured by means of a standard technique. The prevalence of iron deficiency, anemia and iron deficiency anemia were determined according to the latest WHO criteria. Results: The prevalence of iron deficiency, anemia, and iron deficiency anemia were 13.9%, 34.5%, and 7.6%, respectively. (16.3%, 43.7%, and 10.5% in females vs. 10.5%, 21.6%, and 3.6% in males). Disorders were more prevalent in females. Anemia has revealed to have moderate prevalence, where iron deficiency had high prevalence. Iron deficiency was the leading cause of anemia (>50%). Conclusion: More studies are strongly recommended to determine the etiology of iron deficiency; meanwhile, interventional researches seem to be beneficial.

Background: Considering the great importance of iron deficiency, anemia, and iron deficiency anemia as one of the most important indices of public health, the present study was carried out over the high school students in Varamin in 1998-99 to determine the prevalence of iron deficiency, anemia and iron deficiency anemia. Materials and methods: 799 students, including 466 females and 333 males had been randomly selected for this descriptive study. Then, demographic data were collected and HGB, HCT, MCV, MCH, MCHC, ferritin, iron and TIBC were all measured by means of a standard technique. The prevalence of iron deficiency, anemia and iron deficiency anemia were determined according to the latest WHO criteria. Results: The prevalence of iron deficiency, anemia, and iron deficiency anemia were 13.9%, 34.5%, and 7.6%, respectively. (16.3%, 43.7%, and 10.5% in females vs. 10.5%, 21.6%, and 3.6% in males). Disorders were more prevalent in females. Anemia has revealed to have moderate prevalence, where iron deficiency had high prevalence. Iron deficiency was the leading cause of anemia (>50%). Conclusion: More studies are strongly recommended to determine the etiology of iron deficiency; meanwhile, interventional researches seem to be beneficial.

Background: Alopecia areata is a prevalent dermatologic problem, which has known side effects in case of leaving untreated. Its pathology is still remained unknown. Previous studies have suggested association between thyroid disease and alopecia areata, so the present study has been conducted over the patients referring to Booali hospital since 1999 till 2000. Materials and methods: 70 individuals had entered this case-control study and were distributed in two groups. Groups were matched according to the sex and age. Alopecia areata was diagnosed using clinical criteria. TFT (T3, T4, TSH, T3RU) and ANA were done for all candidates. The diagnosis of thyroid disease was made according to the clinical features as well as laboratory results. Fisher test was used for data analysis. Results: Among 35 candidates in each group, 18(51%) were females and 17(49%) were males, with mean age of 23±10 yrs. Thyroid disease was not noted in the control group, however, 11.4% of the patients in the case group had revealed to have thyroid disorder. The difference was statistically significant (p<0.06). Conclusion: Thyroid disease has significant association with alopecia areata, so an experimental study is strongly recommended to determine the efficacy of thyroid disorder treatment on alopecia areata.

Background: Cardiovascular disorders are among the most common disease of human societies. Determining the pathogenesis of disease is of great importance, where controversies have arisen about infectious disease, so the present study was conducted over the patients referring to a private clinic in Tehran in 1999-2000 to determine the relationship between cardiovascular disease and damidia, helicobacter pylori, and cytomegalvirus infections. Materials and methods: 200 individuals had entered this case-control study. Antichlamydial, helicobacter pylori, and CMV IgG were determined and their relation with disease incidence was noted. Results: Anti-CMV IgG was reported 88% and 86% in the case and control group, respectively (NS). These figures were 23% and 22% for anti-chlamydial IgG (NS); and 71 % and 54% for anti-HP IgG, respectively (p<0.02). Conclusion: Results have revealed that he1icobacter pylori infection can increase the incidence of cardiovascular disease by two times. So further studies such as demarcating HP infection in affected vessels by means of histochemical staining or inquiring infectious agents by PCR are recommended.

Background: Migraine is a common debilitating familial disorder that is manifested by unilateral pulsatile periodic headache. Its prevalence is under discussion. Regarding the controversies arisen about the prophylactic dosage of sodium valporate, the present study was carried out over the patients referring to Loghman Hakim hospital in 2000 to compare low and high dose of sodium valporate. Materials and methods: 60 patients had been selected for this clinical trial of cross-over type. Migraine was diagnosed according to the criteria of International Association of Headache and its severity was described as mild, moderate, and severe. Patients were randomly distributed in two groups of case (receiving 400 mg/d) and control (receiving 1000mg/d). After 8 weeks, groups were exchanged. Drug effects on headache severity, duration, and frequency was recorded. Finally, results were analyzed. Results: 60 patients, including 73.3% females and 26.7% males with mean age of 27.l±8.6 yrs had entered this study. The frequency of headache was 3.43±1.03 attacks each month before the therapy, and the duration was 12-24 hrs in 52% of the patients.22% had reported moderate headache, whereas the remaining 78% had been suffering from severe headache. 6 patients of the control group have missed our study due to drug intolerance. Following the treatment, the frequency of headache was reported 1.29±0.71 and 0.33±0.51 attacks/month in the control and case group, respectively (p<0.0001). 63% of the patients receiving 400 mg/d sodium valporate have experienced headache periods of less than 12 hrs, but longer periods (greater than 12 hrs) in case of receiving 1000 mg/d. Conclusion: Sodium valporate has better prophylactic out come with lesser side effects if prescribed at the dosage of 400mg/d, however, attacks are exist via this dosage, so further studies are highly recommended.

Background: Determining the gestational age is of great importance in predicting the outcome of a pregnancy and fetal growth. Different parameters are used to estimate fetal age, where their accuracy is under question. The present study was carried out over the parturients referring to Shohada Tajrish and Loghman Hakim hospitals during 1998 till 2000 to compare these parameters Materials and methods: 200 parturients with determined LMP and GA of 16-41 weeks who had not any clinical history of known disease (HTN, DM...) had entered this study. SL (Scapular Length), FL (Femoral Length), BPD (Biparietal Diameter), and AC (Abdominal Circumference) were all measured for three times by a radiologist. Abnormal fetus, IUGR, and abnormal amniotic fluid volume were our exclusion criteria. Results: 200 parturients with mean age of 25.5±7.5yrs and GA of 16-41 weeks were studied. Different indices have revealed to have significant relationship with fetal age. In Iranian fetuses, AC is of great importance and is a determinant factor. Conclusion: SL of Iranian fetuses is different of standard criteria. SL and FL have significant correlation with GA, so employing these factors are highly recommended.

Background: Cwamydia trachomatis has important role in fallopian tubes pathology and prevalence of tubal infertility. With respect to the sexual relations in Iran, it seems as if our findings should be different of other societies, so the present study was conducted over infertile women referring to Sarem Medical Center in Tehran to determine the relation between chlamydia trachomatis infection (diagnosed via ELISA technique) and tubal infertility (diagnosed through laparascopy). Materials and methods: 30 females without tubal obstruction and 35 with tubal obstruction had entered this case-control study. T-test, chi-square, and fisher's exact test were used for statistical analysis. Groups were matched according to the following criteria: age, husband's age, duration of marriage, duration of infertility, using contraceptive methods, previous pregnancy, previous appendectomy. Results: Considering border of 100units/ml; no statistically significant difference was seen between groups regarding positive IgG and IgM. No one has been reported to have positive IgA. Changing border to 200units/ml, again no statistically significant difference was seen between groups regarding positive IgG. however, no positive IgA and IgM was reported in candidates. Considering average dosage of immunoglobulins, significant differences have been reported in IgM level. Conclusion: Results have revealed no correlation between anti chlamydial antibodies and tubal infertility. Further studies are required to establish this theory.

Background: Violence against pregnant women is a prevalent problem and its-induced short term mental and physical complications are of great importance. We have conducted the present study over the parturients referring to coroner centers in Tehran to determine the violence-induced short-term complications. Materials and methods: 104 pregnant women complaining of violence that have referred to determine their treatment duration had entered this descriptive study. Demographic data, obstetric and non-obstetric short-term complications, mental complications including marital stress, self confidence, behavioral, physiologic, and cognitive anxiety, depression, and mental health were all determined and recorded. Results: Physical and mental complications were reported in 84.6% and 63.5% of the candidates, where 55.8% of them have complained of both. Actual prevalence of physical and mental complications was estimated 77-91%, and 58-68%, respectively. Obstetric physical complications were vaginal bleeding (26%), fetal death (9.6%), abortion (7.7%), preterm delivery (3.8%), however, non-obstetric physical complications were bruising (71.2%), bleeding (14.4%), hospitalization due to injury (8.7%), and fracture (2%). Meanwhile, Shortterm mental complications were reported as below: behavioral anxiety (68%), depression (52%), marital stress (48%), lack of general health (45%), lack of self-confidence (24%), physiologic anxiety (14%), and cognitive anxiety (9.6%). Conclusion: Violence-induced short-term complications should be taken into account more seriously in pregnant women. With respect to the prevalence, severity, and its known complications, multicentric studies are highly recommended.

Background: With respect to the prevalence of head louse infestation and its known complications, the present study was conducted over the school-aged children in Shahriar in 1993 with the aim of identifying the infestation rate of head louse and the effects of several pediculocides such as Coop ex, Ectopar, and Cit. Materials and methods: First of all, in a descriptive study, 1921 children were randomly selected and observed for the detection of head louse at different stages of development. Then, in the second phase a clinical trial was performed on 48 infected children. They have been randomly selected out of 304 infected individuals and were treated with Coopex, Ectopar, or Cit. They were reexamined after a week. Results: The total infestation rate of 15.8% was achieved of which 8.2% were males and 24.3% were females. In females, long hair has increased the chance of infection by 2.4 times. Coopex powder (containing permethrin), Ectopar shampoo (containing gamma benzene), and Cit shampoo (containing pyrethmm) resulted in disinfecting of head louse in 18.8%, 56.2%, and 93.7% of the cases, respectively (p<0.0005). Conclusion: Further studies are strongly recommended in other parts of Iran. With respect to pediculocides- resistant head louse, employing stronger materials should be investigated.

Background: Health care workers such as laboratory staff are encountering with patients and infective materials due to their occupational status. So, they could be suitable carriers for other people. The present study was carried out over laboratory staff of 12 hospitals in Shahid Beheshti University of Medical Sciences to determine the prevalence of intestinal parasite. Materials and methods: 320 staff was randomly selected for this descriptive study. Stool samples were examined by direct smear, formalin-ether concentration and modified ZeilNeelsen staining. Results: 320 staff, including 62% females and 38% males had entered this study. The prevalence of intestinal parasites and pathogenic parasites were 51.9% and 10.3%, respectively. The most common protozoan was Blastocystis hominis (40%), however, entamoeba histolytica and giardia lamblia were reported in 5.6% and 5.3% of the cases, respectively. Conclusion: High prevalence of intestinal parasites is found in laboratory staff. Interventions and further studies seem inevitable.

Background: With respect to the recently increased rate of abortion and the role of bacterial infection and also controversies arisen about mycoplasma infection, the present study was carried out over women referring to university hospitals in 1999 due to abortion. Materials and methods: In this descriptive study, bacteriologic studies were achieved over the specimen obtained from women with GA of less than 20 weeks referring due to abortion and candidated for D&C. PPLO broth with urea and ampicillin (pH=5.5) or PPLO with arginin (antibiotic-free with pH=7) were used to determine M. hominis, D. urealyticum, and L. monocytogenes. Meanwhile, special PPLO broth and P ALCAM were used for bacterial isolation. Results: 114 women with mean age of 30±10 yrs had entered this study. Microorganisms were isolated in 73.7% of the cases, of which D.urealyticum, M.homonis, and other microorganisms were reported 8.8%, 7%, and 84.2%, respectively. Conclusion: With respect to the prevalence of mycoplasma infection and the possibility of non-vaginal symptoms, in case abortion, samples of abortion product should be taken even if fever, septic shock, or other symptoms are presented.

Background: Considering the hazards of hospital waste water in case of paying less attention to the correct was of its disposal, any study of hospital waste water disposal seems to be vital. In the present study we have surveyed the effluent quality in hospitals of Shahid Beheshti University of Medical Sciences, in 1998. Materials and methods: 12 hospitals had entered this descriptive study. The hospital wastewater disposal and the efficacy of treatment plants were studied. Sampling was performed of influent and effluent for three times in different seasons. Then, BOD, COD, SS, coliforms, number of cysts and eggs of parasites like giardia and ascaris were all determined. Results: Results have revealed that only 5 hospitals (Masih-Daneshvari, Mofid, Emam Hossein, Modarres, and Mahdieh) had wastewater treatment plants, working under aeration and activated sludge method. Although the studied parameters in the effluent were less than those in influent, the rate of indicators was still higher than standard limits. Conclusion: Among the studied hospitals, Masih-Daneshvari wastewater treatment plant had better efficacy since pollution indicators have obviously decreased in the effluent. The amount of coliforms was 2400 that is higher than the standard limits (1000 in 1000ml). Giardia had been removed just in Masih-Daneshvari treatment plants, meanwhile, ascaris eggs were not found in some hospitals' wastewater that could be due to heavy mass and their settlement. Finally, it should be noted that wastewater treatment plants have an unsatisfactory condition in our hospitals, this seeks more seriously interventions.

Background: Growth monitoring and promotion (GM/P) program is presented as a valuable strategy in eliminating protein-energy malnutrition, particularly in underdeveloped countries. Nutritional status of under-5 years old children strongly depend on their mothers" knowledge and practice, where training yielded in GM/P programs affect their knowledge and practice. In the present study, nutritional knowledge, attitude, and practice of mothers attended on Health Care Centers of Orumia had been determined with respect to the growth monitoring program. Materials and methods: In this descriptive and cross-sectional study, 80 mothers attended on urban Health Care Centers and 135 on rural centers were randomly selected. Initial data were collected through questionnaire. Results: Results have revealed that 38.8% of urban and 15.6% of rural mothers had little knowledge of GM/P program. Meanwhile, 14% of urban and 86.7% of rural mothers had begun GM/P program within the first month. GM/P program was considered to be a useful action by 85% of urban and 96.3% of rural mothers. Nutritional practice had a poor condition, so that 89.2% of urban mothers and 94.1% of rural mothers who have an upper-one-year-old child had not performed according to the standard directions of health ministry. Complementary food was begun after 4.4±1.4 and 4.3±1.6 months in urban and rural centers, respectively. Weaning stage was begun after 21.1±3.7 and 24.2±5.3 months in urban and rural centers, respectively. Conclusion: Results have indicated that GM/P program had a long way to meet standard criteria, so to create motivation in mothers, management systems should act more effectively.

Background: Adolescence is a period of marked physical, physiological, emotional and social changes. These adolescent girls are the future mothers and therefore a good knowledge and positive attitude from the very early phase will go a long way in realizing. The present study was conducted over the adolescent female students in Tehran, 1998-99, to determine their knowledge and attitude about breastfeeding. Materials and methods: In this descriptive study 5 geographical areas in Tehran were chosen via a simple random sampling based on population size, totally 630 high school students were selected. A questionnaire covering demographic data, students' knowledge and attitude about breastfeeding, their parents' level of education, their jobs and their family size was filled for each candidate. Results: 630 students with mean age of 16±0.8 yrs birth rank of 2.6±1.7 and family size of 5.4±1.5 had entered this study. Their mother and father mean age was 40.7±7.2 and 47.1±5.1 yrs, respectively. 82.2% of their mothers were housewife, and 30.3% had higher education (university degree). According to the following four categories (very good, good, weak, and very weak), students" knowledge and attitude were (5.4, 57.9, 31.9, 4.8%) and (8.2, 71, 15.2, 5.6%), respectively. Conclusion: Results have revealed that knowledge and attitude of adolescent girls toward breastfeeding was relatively satisfactory and positive. Educational program could increase the prevalence of breast feeding in this community.

Background: Chronic low back pain is a prevalent problem that could lead to unsatisfactory complications in case of leaving untreated or even mistreated. The present study was conducted in 1999 to determine the attitude of orthopedic surgeons and neurologist toward chronic low back pain. Material and methods: 394 specialists were randomly selected for this descriptive study. Their opinion toward patients' admission, somatic or mental source of disease, diagnostic technique in case of mental source of disease, therapeutic approach, and postoperative approach were all determined via a questionnaire. Results: 177 questionnaires were received. 6.98% of the specialists had admitted these patients. According to the results, somatic source of disease was noted in 86% of the cases, where occupational origin was mainly stated. In case of mental source, stress, depression and anxiety were the main etiologic factors. Conclusion: Specialists have believed that chronic low back pain is a disease with somatic origin, and even in case of mental problems, somatic therapeutic approach is the first choice. Further studies are strongly recommended.