Journal of Kermanshah University of Medical Sciences
Year:2009 | Volume:12 | Issue:4 (39)|Papers Count:11

Introduction: William's flexion exercise is recommended for any kind of non-specific low back pain. However, no clinical trial study has yet determined its effect. This study examines the effect of William's flexion exercise on pain intensity and disability in patients with chronic non-specific and referral low back pain.Materials and Methods: This clinical trial study included 32 patients with CLBP, assigned into 2 groups of non-specific low back pain (n=16) and referral low back pain (n=16). Both groups received a two-week Flexion exercise intervention. Data was collected using Mc-Gill pain questionnaire and Roland Morris disability questionnaire completed once on the first and again on the last day of the period before and after the intervention. The data were then analyzed using independent and paired t tests.Results: For the non-specific group, Mc-Gill pain score decreased from 17.6±3.4 to 7.1±2.8 (P<0.05), and in referral group from 23.2±4.7 to 8.8±3.3 (P<0/05). A significant statistical difference was observed in the mean score obtained from Roland Morris disability questionnaire after the treatment (p<0.05) for the two groups. Disability score for the non-specific group was lower than that of the referral group.Conclusion: Our result supported the effectiveness of William's flexion exercise in reducing the pain in patients with chronic non-specific and referral low back pain. In terms of reducing disability, better result was observed for the non-specific group compared to the referral group.

Introduction: Frying is one of the most popular cooking methods. However, harmful substances are created during the frying process, with the stability of oil negatively affected. This study evaluates the stability of fatty acid content of several cooking and frying oils available on the Iranian market during the process of frying.Materials and methods: Samples from 5 different frying oils and 12 samples of oils for cooking (natural lipids) were collected. All the frying oils as well as 6 samples of oils for cooking were subjected to fatty acid analysis using high performance liquid chromatography (HPLC). Frying performance of all the samples was chemically analyzed before and after the frying. Data were analyzed using a descriptive method.Results: The highest amount of trans fatty acids (up to 26.3% of total fatty acids) was found in some frying oils. The maximum and minimum of the sum of trans and saturated fatty acids were 33.7% and 5.9%, respectively. Chemical parameters of oils degradation were increased for the over-used frying oils. The parameters also went up for the cooking oils after the frying.Discussion: This study shows a low stability of the frying oils available on the Iranian market making them unsafe for over using for the frying purposes. In addition cooking oils are not recommended for frying at all.

Introduction: Cancer is considered to be one of the preventable and manageable diseases. To design an intervention program aimed at prevention and management, data on the level of knowledge of the disease among the target population is required. The present study examines the level of awareness about the risk factors and signs of cancer based on a comprehensive study among the Tehran general population. It also presents the factors affecting the level of understanding of the disease among the sample.Materials and Methods: This cross-sectional study included 2500 people aged over 18 in Tehran. The sample was selected using multistage cluster sampling and the data collected through a comprehensive questionnaire. The obtained data were analyzed using a special regression model i.e. latent class regression.Results: Women comprised %52.9 of the participants. %47.1 of the sample was aged between 18- 30 and the rest were over 30 years of age. Overall, %45.4 of the subjects had obtained some information about cancer. The most important sources were mass media and self study at %82.6 and %48.3 respectively. High knowledge about risk factors and warning signs were obtained in %12.2 and %24.2 of participates respectively. The most important determinant of knowledge was education. The other important determinants were gender and family history. The women and participants with a family history of the disease had higher chance to be classified in higher knowledge level group. Marital status was only positively correlated with awareness of the signs.Conclusion: The results showed a low level of awareness about the risk factors and the warning signs, in particular for the ones that require specific information on the part of the participants. Findings of the study provide valuable guidelines toward the formulation of relevant cancer prevention strategies, especially in the area of education.

Introduction: Glycoconjugates are molecules with a carbohydrate bounded to proteins. The terminal sugars of glycoconjugates are specific identified by lectins. Glycoconjugates play an important role in various developmental processes. This study examines the developmental changes in certain glycoconjugates during the development of Meckel's cartilage through lectin histochemistry.Materials and Methods: 10-15-day-old Balb/C mice embryos as well as 18-day-old fetuses were fixed in formalin. Serial sections of the samples were gathered for incubation with three types of conjugated lectins with HRP enzyme including: Glycine max (SBA) specific to N-acetylgalactoseamin (GalNAc), Arachis hypogaea (PNA) specific to Galactose / N-acetylgalactoseamin (Gal/GalNAc) and Maclura Pomifera (MPA) specific to Galactose (Gal). The enzymatic reactions were then studied using optical microscope.Results: Our results indicated that terminal carbohydrate of GalNac and terminal disaccharide of Gal/GalNAc were presented from initiate condensation of mesenchyme cells in the center of first branchial arch until the end of Meckel's cartilage development. But terminal carbohydrate of Gal was noticed from day 13 on.Conclusion: Our study showed that glycoconjugates with terminal carbohydrate of Nacetylgalactoseamin and terminal disaccharide of Galactose / N-acetylgalactoseamin have critical role in condensation of mesenchyme cells, cartilage formation and chondrocyte differentiation to osteocyte. Furthermore, glycoconjugates with terminal carbohydrate of Galactose probably play an important role in chondrocyte differentiation to osteoblasts.

Introduction: Acute renal failure (ARF) is a common problem in the neonatal intensive care unit (NICU). In most cases, ARF is associated with other conditions such as sepsis, perinatal asphexia and prematurity that could result in mortality and morbidity. This study examines the prevalence, the course of illness, early prognosis and risk factors associated with development of ARF in the neonatal period.Materials and Methods: This descriptive study included 938 neonates admitted to Kermanshah Razi Hospital. ARF was defined when serum creatinine level  ³1.5mg/dl with the serum urea³50mg/dl and course of illness was compatible with ARF. Convenient sampling was carried out, selecting the patients based on the above mentioned criteria. Medical records of these patients were reviewed and the data were then analyzed using SSPSS software, chi- square t test.Results: 32 out of 938 patients (3.41%) had ARF, of whom 62.5% were males and 37.5% females. The figure for term, preterm, and post term neonates was 75%, 15.63% and 9.37% respectively. 68.75% were aged 1-5 with 31.25% between 6-28 days. While a normal birth weight was observed in 50% of the cases, 43.75% of the patients had a low birth weight, with 6.25% belonging to the very low birth weight group. Sepsis was the most common condition at 38.88%, followed by pneumonia and dehydration at 8.34% each. Associate congenital anomalies were present in 37.45% of the cases. Frequency of oliguric renal failure was 18.75% and mortality of neonates with ARF was 62.5%. Therapeutic interventions were supportive in 92.75% of the cases, and peritoneal dialysis was required for the other 6.25%.Conclusion: The study showed that at Razi hospital, ARF was commonly associated with preventable conditions such as sepsis. In most cases, patients can be managed using conservative therapy with no need for dialysis.

Introduction: Colorectal cancer (CRC) is one of the most prevalent cancers in the world. Genetic disorders and dietary habits play a part in CRC. The most important cancer suppressor gene is P53. Different mutations rates in 7th exon of p53 gene are reported in different areas which may have a relationship with prognosis of CRC. This study examines the relationship between mutation in 7th exon of P53 gene and the prognosis of CRC.Materials and Methods: This descriptive analytical study included 80 CRC cases hospitalized in Isfahan between 2003 and 2007. The DNA samples were extracted through phenol chloroform isoamil alcohol. In genetic department of Isfahan medical faculty. The 7th exon of P53 gene was amplified using specific primers in a PCR assay. After that mutation was detected by gel electrophoresis and SSCP analysis. P53 gene expression was detected by immunohistochemical methods. Data was analyzed using chi-square test.Results: From the total of 80 specimens, 4 (5%) had mutation in 7th exon. The positive specimens demonstrated over expression for p53 gene. There was a significant (p<0/001) relationship between 7th exon mutation and over expression of p53 protein. However, the relationship between stage tumor and mutation in 7th exon of p53 gene was not significant (P>0.05). Two samples with mutations as well as one sample without mutation showed metastases in the liver tissue. The prognosis of CRC was 3 years after diagnosis. And follow-up was less in patients with mutation compared to those without mutation.Conclusion: The result showed that all mutations in 7th exon of p53 are accompanied by p53 over expression. The mutation in 7th exon of p53 gene is associated with poor prognosis in CRC.

Introduction: Metalworking fluids (MWFs) are widely used in metal working operations for cooling down, lubricating and reducing the friction between tools and work pieces which result in controlling the heat produced. Exposure to MWFs causes several adverse effects including respiratory problems, skin diseases, cancer and even infertility. This study examines workers’ exposure to MWF mist and the factors affecting the dispersion of it in an automobile factory.Materials and Methods: This cross-sectional study was carried out in metal working units (producing cylinder and cylinder head) of an automobile manufacturing factory during two seasons of spring and summer. From the total of 300 people working in the factory 75 workers were randomly selected. 38 workers were tested for total particulate status and 37 for the thoracic particulate status. The MWF used in unites was soluble. Using NIOSH 5524 method, sampling and exposure evaluation was carried out with personal air sampling pump, closed-faced 37-mm cassette, 37-mm diameter 2- mm pore size Teflon and personal cyclone. Thermal anemometer was used to measure the air temperature and air velocity. Data were analyzed using T, mann withney, ANOVA, regression, Pearson correlation coefficient tests.Results: The mean of workers exposure to total and thoracic dust were 2.65 ± 1.3 and 1.64 ± 0.95 mg/m3 respectively. The above values for MWF mists were 2.19 ± 0.92 and 1.28 ± 0.88 mg/m3 respectively. The results indicated a higher exposure to MWF mists in Terimery workplace than that of Donobat and Terimery Cylinder Head (P<0.05). Temperature had positive effect on MWF mists dispersion (P<0.05).Conclusion: All exposure levels were under the threshold limit value level (TLV-TWA, PEL = 5 mg/m3). However, they were well above the NIOSH Recommend Exposure level (REL = 0.5 mg/m3). The result showed that air temperature is an important factor in increasing MWF mists production and dispersion (r= 0.572).

Introduction: The examination of radiographics repeat rate and the causes are considered as one of the main factors in assessing the performance of radiographers and the function of the equipments in radiography services. The analysis of repeated films can reveal sources of the errors and areas where improvement can be made. Apart from imposing additional charges, the repeats are responsible for unnecessary exposure to a higher radiation dose on the part of the patients. There have been some inconsistent reports of the repeat rate in kermanshah radiography centers. Therefore, this study was designed and carried out in some selected hospitals in Kermanshah in 2006.Materials and Methods: For this descriptive study, plain X-rays were examined over a period of five months. Repeated films were collected by quality control technicians. Demographic information of the patients and the radiographers as well as the causes of the repeats was determined. They were then recorded into a checklists designed based on the research specific objectives. Data were then analyzed using a descriptive method.Results: A total of 11109 radiography was performed over the period. 730 repeated cases were identified. The repeat rate was 6.6%. The highest repeat rate belonged to Imam Reza Hospital at 8.5%. The most important cause of the repeat came out to be unsatisfactory exposure at 2.7%. Skull and sinuses were the two most repeated a ray (12%). Patient aged 76-90 (7%) and the uneducated (7.3%) scored the highest in terms of the number of the repeats they had. The other figures for the repeats were 6.8%, in females and 6.4% in males and in urban 6.5% and rural 6.8%. A high repeat rate (6.9%) occurred when the radiographer and the patient were of the opposite sex. Radiographers with a work experience under 2 years scored higher on the number of the repeats (9/8%), with students of radiography coming out second (9%) as opposed to technicians who had the least number of the repeats (6/7%).Conclusion: The result revealed the repeat rate (6/6%) consistent with those reported in other similar studies. Yet such rate could not be tolerated for some centers and also some specific areas of the body. Therefore, a number of preventive measures including regular calibration of equipments, in-service training of the staff, employing permanent radiographers in a number proportionate to the work load, giving instruction to the patients, supervising the student radiographers, using new digital radiographic equipments could be implemented to reduce the repeat rate and also improve the safety and efficiency of radiography centers.

Introduction: Depression and anxiety, in particular panic disorder are considered common psychological problems associated with major functional disorders. On the other hand, some medical disorders such as thyroid disease may have the same manifestation or accelerate the process. This following is a closer examination of the issue trough the study of a group of patients referred to a psychiatric clinic in Zanjan.Materials and Methods: In this descriptive study, patients with major depression or panic disorder (referred to the psychiatric clinic or admitted to the ward) were tested for thyroid hormones using immune chemilumine scence method. Results were then collected and analyzed using SPSS.Results: From the total of 103 patients , 47 patients were diagnosed with major depression (45.6%), 37 patients with panic disorder (35.9%), and 19 patients had both (18.4%) at the same time. 18.4% of those suffering from major depression were diagnosed with subclinical hyperthyroidism. Decrease in T4 level was only observed in 2 patients with depression and 2 patients with panic disorder. T3 level came out normal for all the patients.Conclusion: The result of our study, in terms of the prevalence of thyroid disorder in patients with major depression and panic disorder, was consistent with the previous studies where a range of 0-9.7% was reported. Based on the 6.38% prevalence of thyroid disorders in patients with major depressive disorder and %5.4 prevalence of thyroid disorders in patients with panic disorder observed in this study, early diagnosis and treatment of thyroid problems could soon return the patient to normal life.

Introduction: Catamenial pneumothorax is a rare disease caused by presence of endometrial tissues in chest cavity showing itself with pneumothorax 24 to 48 hours after the beginning of menstrual period . A case of Catamenial pneumothorax is presented here.Case presentation: The case was a 17-year-old young woman admitted to hospital with symptoms and signs including chest pain, dyspnea, tachypnea and decreased breath sounds in right hemithorax started with her menstrual period. The patient had a history of similar attacks in her previous menstrual periods. Right pneumothorax was observed in the x-ray. Tube thoracostomy was inserted and chemical pleurodesis was administered. Treatment with decapeptil (GNRH analog) injection continued for 6 months.Conclusion: Diagnosis of the disease is clinical. Early diagnosis and treatment is recommended for all the patients in reproductive ages with dyspne, chest pain and pneumothorax as well as a history of recurring symptoms during the previous menstrual periods.