Journal of Kermanshah University of Medical Sciences
Year:2008 | Volume:12 | Issue:2 (37)|Papers Count:13

Introduction: Wound healing has always been one of the challenging issues in medicine, of which the details and treatments concern researchers the most. Different agents and drugs affecting wound healing process have been the subjects of many studies. One of these agents which is experimentally used for many years, is the animal peritoneal fat. Yet, there is no documented study of its effects and mechanism in wound healing process. This study is aimed to examine the effect of peritoneal fat in different stages of the process.Materials and Methods: 36 Wistar male rats were randomly assigned into 6 groups (6 rats in each group) and then they had their lumbar skin punched. Peritoneal fat was administered locally for 3 of the groups while the other half received Vaseline (as placebo) as treatment. One group of the recipients of either method was then sacrificed on the first, third, and fifth day from the punching (a pair of two different groups each day). Specimens from wound area were histologically studied after hemathoxylin and Eosin staining. Data were analyzed using t-test.Results: Statistically significant increase in neutrophil cell percentage and decrease in lymphocyte percentage was observed in interventional group in comparison with control group on the first day (P<0.05). For the third day, there was a significant increase in macrophage percentage (p<0.01) and a meaningful decrease in neutrophil percentage (P<0.05). Angiogenesis was significantly different between interventional (22.194±2.02) and control (15.22±3.1) groups (P<0.05).Discussion: Based on the results of the study, peritoneal fat administration proved to have positive effects on the process of wound healing. More studies are needed to standardize this agent and its usage in human subjects.

Introduction: The pain produced by intravenous (IV) cannulation is the most important incident associated with invasive ways experienced by every young patient. However, there are some techniques that can be used to reduce the severity of the pain. Therefore, this study examines the effects of two methods of relaxation and distraction techniques- Music and Rhythmic Berating on the pain reduction during blood transfusion.Materials and Methods: This clinical trial included 36thalassemic patients aged 6 - 12 years. The sample was collected through census. The sample was all in the same condition-they were all conscious, able to deal with psychological needs with no other disease and need to take any analgesic.Data were collected using a questionnaire including demographic section and two standardized pain scales-self reporting scale (OUCHER), and behavioral scale (CHEOPS). Pain severity was measured in three intervals for each patient - before using any methods, after using breathing techniques and then after using the music technique. In this way, each patient was measured against himself. The collected data were then analyzed using descriptive and analytic statistics.Results: Findings of the study revealed a reduction in the severity of pain through rhythmic breathing technique (p=0.0001) and music technique (p=0.0001) with latter being the more effective (p=0.0001) since the headphones were requested by the patients even after the study.Conclusion: Based on the result of the study, the two methods of music and rhythmic breathing technique are recommended when dealing with younger patients in all the sections. These methods may also be implemented with outpatients to prevent the negative effects of sever pains as they provide us with - cost, yet effective ways of pain reduction in terms of implementation and education.

Introduction: Burn injuries, in many ways, are considered to be one the most tragic events an individual can experience during his life. In particular, the Iranian province of West Azarbiajan provides one of the most dangerous sites, because of a very cold weather condition imposed by its harsh winters. This study is aimed to provide preventive measures for prevention and treatment of the complications.Materials and Methods: Using hospital files, this cross-sectional study which was carried out in 2005 examined age, sex, burn surface area (BSA), length of hospital stay and case fatality of 639 patients admitted to Imam Khomeini Hospital in Urmia. T test and SPSS software were used to analyze data.Results: From the total of 639 patients 310 (48.3%) were females and 329 (51.7%) were males. Burning with flame accounted for 39.9% of admissions. The mean of age was 23.6±0.4 years with a range of 1-81 years old. Almost 31.8% of admissions were in the 16-25 years age group. The mean length of hospital stay was 7.76 (1-60) days and 21.7% of patients remained for longer than 10 days in hospital. Overall case fatality was 25.9%. Patients with <40% BSA burn had a mortality of 4.9%. The corresponding value for those with >40% BSA burn was 76.7%. Most of the cases had occurred in November (10.95%), July (9.54%) and February (9.23%).Conclusion: Results of the study will help to channel the health care efforts towards prevention and provides a valuable baseline to assess the future efforts. Increasing the quality and quantity of emergency wards could increase the improvement of burn lesion which in turn will lead to the decrease in length of hospital stay.

Introduction: Limb fracture is always accompanied by a sever pain that doctors try to reduce it when they treat such fractures and this in turn results in a better treatment. Hematoma-block is one of the ways that is used to reduce the pain in colle’s fracture. This study examines the clinical analgesia in reduction of Colle’s fracture by Hematoma-block.Materials & Methods: In this quasi experimental survey and using a convenient sampling method, 42 people were included with wrist fracture who were referred to Taleghani Clinical and Educational center within 2003- 2004. Each patient was injected with 10ml of Lidocaine 2% to the area of hematoma of fracture. After aspiration, half of that was injected to the hematoma area again. All samples were studied in terms of starting analgesic effects and its quality. The data was gathered using a check list and then were analyzed by descriptive statistics and Chi two.Results: All samples were in their thirties, and 59% of them were females. After doing Hematoma-block in Colle’s fracture area, 94.1% of the patients experienced no pain or a tolerable one. In 70.5% of the males and 69% of females, the analgesic effects started within 2 minutes. Analgesia duration in 47.5% of the males and 56% of females was 1 hour.Conclusion: Similar to the results of other studies, our study found no significant difference between Hematoma-block and regional intravenous injection. With regard to the side effects of using intravenous injection of analgesic drugs in Colle’s fracture, Hematoma-block is recommended for this kind of fracture. Future studies are needed to provide more insight on the method.

Introduction: In Iran, due to the predominance of calcareous soils, high levels of bicarbonates in irrigation waters, and negligence in the use of fertilizers containing zinc (Zn), little Zn is absorbed by the crops. This study is aimed to determine the serum level of Zn among medical student of Tehran University of Medical Sciences in Iran from 2001 to 2002.Materials and Methods: From 2001 to 2002 using a spectrophotometer (atomic absorption), 320 medical students of Tehran University (137 females and 183 males) were selected for this study. From this total, 125 lived in dorms, 33 in dormitories and 162 at home with their family. Using Chi square test the data were analyzed.Results: The average concentration of Zn in the serum of studied individuals was 74 mg/dl which was below the worldwide average (85 mg/dl) level. The results showed that 64% of the sample suffered from Zn deficiency. Out of the seven different factors which were examined, a significant association was found between the Zn level and martial status, the type of bread, the geographical area they come from and their intake of Zn sulfate capsules. However, there was not any significant association between serum Zn level and sex, the number of sanitary pads used in menstruation period, and the number of people living in the family.Conclusion: One major reason for the widespread Zn deficiency is the consumption of cereal based foods containing low Zn. Cereal enrichment and bread fortification are recommended as possible solutions. However, future studies are needed to determine the extent of Zn deficiency in particular among children.

Introduction: One cause of death among people aged under 40 is trauma which in increasing mainly because of increase in use of vehicles. There has been an increase in trauma and its mortality worldwide, resulting in lost of life years due to the consequent disabilities. However, we can prevent the mortality & complications due to trauma in particular, thorax trauma through intense & urgent care.The present study examines the causes of trauma as well as, methods and results of the treatments of patients with thorax injury in Taleghani Trauma center in Kermanshah.Materials & Methods: In this cross-sectional study, the sample consisted of 630 patients with thorax injury who had been hospitalized in Taleghani Truma Center in a period starting from April 2002 to March 2005. Using a objective-based check list, the data was gathered from the patients' file as to the type of thorax trauma, cares and the treatment results. The data were then analyzed using descriptive methods.Results: 92.6% of the sample was aged 12-69. 64.1% of them had non-penetrating trauma. In 52.4% of cases, the cause of injury was motor vehicle accident. There were no side injuries in 54.3% of the cases. For 36% of cases only a conservative treatment was carried out. 85.9% made full recovery and 4.5% died. Hypovolumic shock was determined as the cause of death in 72.4% of cases .The highest case fatality (30.4%) was in patients aged 70 and over.Conclusion: Results from this study show that people in productive ages are the group at risk. The cause of injury in most cases was motor vehicle accident; with the most common cause of death being hypovolumic shock happened in older people.

Introduction: Everyone who wants to analyze the safety needs to choose one method among all available ways. This study was carried out to identify energies and barriers in LPG storage spheres in a petrochemical complex using ETBA method. It also examines the quantitative evaluation of failure modes and their effects as well as evaluation of effect of FMEA and comparing the results plus the identification of the advantage and disadvantages of the two methods.Materials and Methods: Using an expert team and by ETBA’s worksheets, we tried to identify process energies and risks in accordance with MIL-STD-882 standards. Failure modes, different components and the quantified effects of failure as well as their severity score, occurrence and detectability, and advantage and disadvantage of these methods were assessed.Results: In ETBA study, a total of 30 elements were examined. Each of the elements was qualitatively evaluated. Our results show that there were 10 unacceptable risks, 7 were undesirable, 8 were acceptable but needed to be reviewed and 5 acceptable with no need to review. In studying of FMEA, 29 potentially failure modes were identified.Conclusion: A comprehensive approach for safety assessment such as ETBA is recommended before any risk analysis for the complicated systems either as primary assessment or along with any other type of complicated methods.

Introduction: Unfortunately, the prevalence of traumatic events among children is quite high. These events will result in different kinds of affective, cognitive and behavioral problems. This study examines the frequency of life traumatic events and their psychological impacts in the urban students of Kermanshah in 2006.Materials and Methods: Using cluster random sampling, 475 primary and secondary students from 17 different schools were selected. The students were aged 7- 15. Every child was interviewed using a Life Incidence Traumatic Events scale (LITEs), Child Report of Post traumatic Symptoms (CROPS) and Parents Report of Post traumatic Symptoms (PROPS). The data were then analyzed using descriptive and inferential (chi squire) statistics.Results: Our results demonstrated that 57.5% (274 cases) of the participants - girls 33.8% (161) and boys 23.7% (113) experienced at least one traumatic event in their life. Physical abuse and having a sick person in the family was the most common events coming out at boys 34.1% (162) and 30.3% (144), respectively. The corresponding values in girls were 32.4% (154) and 32.8% (156). Being kidnapped was reported for at least (2%). Sexual abuse came in last with at lease 7 boys (1.4%) and 11 girls (2.3%). Only 8% of the participants had experienced no traumatic life events .PROPS results has shown 40% of girls and 31% of boys scores were greater than the cut of point. The corresponding values for CROPS were 44.5%% and 18% for girls and boys, respectively.Discussion: More than half of the participants had experienced at least one traumatic event in their life and most of them needed psychological intervention. The scale of the events and their serious negative impacts on the sample call for a professional intervention as well as psychoeducation for the families.

Introduction: Chronic hepatitis B and C will result in limitations of physical and mental functions which in turn reduces the quality of life of the patients. This study examines the quality of life in patients with chronic hepatitis B and C in Rasht Razi hospital between the periods of 2003-2004.Materials and Methods: In this cross- sectional study, 74 patients with chronic hepatititis living in Rasht were selected. Using a convenient sampling, a specialized questionnaire on quality of life among patients with chronic liver diseases, consisted of 29 questions with 7 choices for each question completed by the patients. The questions were about the 6 domains of quality of life (containing: abdominal signs, tiredness, systemic signs, emotion, and activity Then, collected data were analyzed using Kolmogorov-Smirnov and MANCOVA statistical test. The meaningful level of the test was assigned 0.05.Results: The study sample contained 15 (20.27%) and 59 (79.72%) patients with chronic hepatitis B and C, respectively. No significant difference was found between the two sexes. Systemic symptom domain was 23.7±8.1 for males and 17.85±8.3 for female (P=0.007). The highest adjusted mean of quality of life score was belong to abdominal domain and the least one was for emotional domain. The total adjusted mean score and means of all other domains scores were higher for those who had school education compare to those with no/some school education. The total adjusted mean score of quality of life in people with other chronic conditions were lower than those without such condition.Conclusions: The quality of life score was not favorable in patient with chronic hepatitis. No significant difference was found between the treated and untreated patients with chronic hepatitis in any of the 6 domain. This might be related to the social fear or stigma caused by their disease.

Introduction: Digital clubbing is a clinically descriptive term, referring to bulbous uniform swelling of the soft tissue of the terminal phalanx of a digit with subsequent loss of the normal angle between the nail and the nail bed. It is associated with various underlying pulmonary, cardiovascular, neoplastic, infectious, hepatobiliary, mediastinal, endocrine, and gastrointestinal diseases. Finger clubbing also may occur without evident underlying disease, as an idiopathic form.Case presentation: We present a case of clubbing due to foreign body aspiration. A 7 year-old boy referred to our clinic for evaluation of causes of dyspnea from 8 months ago. Growth and development were normal. Past history was negative for other diseases. Physical examination revealed wheezing and clubbing of nails. Other organs were normal. He had treatments for asthma and pneumonia for along time. Bronchoscopy was done and foreign body was found and removed.Conclusion: This was a rare case of clubbing due to foreign body aspiration. Observation of clubbing might mislead us toward organic diseases. However, foreign body aspiration can cause clubbing as well.