Journal of Kermanshah University of Medical Sciences
Year:2002 | Volume:6 | Issue:1|Papers Count:9

History & Objective: percutaneous coronary angioplasty (PTCA) had found a widespread acceptance in treatment of coronary artery disease (CAD). Regarding a controversy being raised about early complication of this method in literature, the present study was aimed to study and evaluate the result of application of this method immediately and one year after operation.Materials & methods: The subjects included 46 patients between 40 and 60 years of age (32 male and 14 female). 32 of cases had single vessel, 7 cases had two vessel and 4 cases had three vessel disease. 20 patients underwent stent implant (i.e. 4 cases of primary stenting and 16 cases of Bailout stenting).tread mill test was done for all patients before and 4 months after PTCA.Results: Pre- and post PTCA tread mill test was positive in 46 and 18 cases, respectively. No re-stenosis, severe bleeding, myocardial infarction, or mortality were reported. Discussion: Since the present study suffers from small number of cases, further studies are required to give a better understanding of the issue.

History & Objective: One of the most important issues in scientific research is determination of sample size for caculation of statistical indices such as mean and ratio. Researchers, usually use a fix confidence interval of 95%, a test power of 90% with fixed error and one or two sample formula to estimate a fix sample size. Due to some ethical, administrative and economical reasons using fix sample size in clinical trials is not practical. Group sequential methods are part of design and analysis of experiments. In group sequential methods, we try to solve problems by reducing the sample size and choosing a suitable test such as Pocock, OBrien-Fleming, Lan-DEMets and the like. The purpose of this study is to evaluate the application of group sequential methods in determination of sample size and to analyze the results of the effect of single and multiple courses of corticosteroid therapy on Pretem Premuture Rupture of Memberance (PPROM) with a gestational age of 28-36 weeks. Results: Analysis of data showed application of group sequential method reduced both the sample size and the length of the study.

History & objective: Standard 12-lead electrocardiography (ECG) is not a sensitive means of diagnosing acute posterior myocardial infarction (MI). In this study we are reporting the value of posterior leads (V1, V8,V9) in diagnosis of posterior MI.Materials & methods: We used posterior leads, in addition to standard12-lead ECG, in 60 patients with acute MI, and compared the diagnostic result with technetium pyrophosphate scan that obtained within 72 hours of patients admission at hospital.Findings: 27 patients (45%) showed ST-elevation in at least two posterior leads. Technetium Scan (TS) showed an uptake in 24 of these 27 patients and in 3 patients with no ST-elevation. True positive, false negative, true negative, and false positive rates were 88.9%, 11.1%, 90.9%, and 9.1%, respectively. Sensitivity, specificity, positive and negative predictive value, and test accuracy, in diagnosing acute posterior MI were 88.9%, 90%, 88.9%, 90%, and 90%, respectively.Discussion: Considering high sensitivity and specificity of using posterior leads, we recommend routine use of these leads in patients suspected of having acute MI, became thrombolytic therapy of such patients will decrease the mortality rate.

History & Objective: Illicit drug Use is a serious social problem in Kermanshah. Due to lack of enough information about prevalence of drug-abuse, present study was carried out to determine the prevalence and demoghraphic information about drug users in this city. Materials & Methods: The subjects of this descriptive study included 4005 cases who were refferd to Emergency Units of Imam Khomini, Taleghani and Shaheed Fahmideh hospitals between 1998 and 1999. Demographic information of the subjects was collected through a questionnaire. To detect the presence of morphine in urine, urine samples of all cases were analyzed by screening and confirmatory methods. For rapid identification, immunochromatography technique, was used as initial screening. Then the positive results were confirmed by Thin Layer Chromatography (TLC) method.Results: Application of screening techniques revealed 12.4% of the total population of the study (4005) were positive , while in confirmatory method only 4.7% of them were positive. 3454 of cases were male and 496 were female.Discussion: Prevalence of drug abuse was 4.7 % in this study. Since the chances of interference of some drugs, such as codeine in rapid techniques is quite high; the positive results of screening methods are only presumptive. Hence to confirm the results of rapid techniques for detection of opium in urine samples, it is recommended to use confirmatory methods such as TLC.

History & Objective: Regarding the high prevalence of Musculoskeletal Disorders (MSDs) among miners and lack of information concerning Manual Material Handling (MMH), this research was designed to identify these disorders and their risk factors through active surveillance process and 1991 revised NIOSH lifting equation for assessment of MMH surface stone mines in Kermanshah during 2001.Materials & Methods: This descriptive-analytical study was conducted on 36 surface miners. The data collecting tool was a health risk /symptom survey questionnaire which was completed through direct interviews. The MMH tasks were assessed by observation and 1991 revised NIOSH lifting equation. The results which was processed by descriptive statistics analyzed by Pearson Correlation test. Results: The subjects of the study included 36 miners between 23-55 (35.39 ± 8.98) with a work history of 11±7.7 years. All the workers had experienced musculoskeletal discomfort in the previous year. The causes of discomfort were said to be heavy manual lifting and work pressure. The severity of injury was equal to missing of 5469 full or limited work days in 36 workers during the previous year, totally equivalent to 17.5 work forces. The average Recommended Weight Limit (RWL) among miners was 19.79 lb (6.69Kg). There was a significant positive correlation between age and degree of discomfort of the subjects during the interview and their worst discomfort episodes, the duration of and frequency of discomfort episodes(P<0.05).Discussion: This research indicated that high prevalence rates of MSDs miners can be attributed to frequent load handling. The quality of MMH was not ideal among population of the study. Precise analysis of working conditions in mines along with identification of risk factors and ergonomic training programs will help to reduce discomfort among miners.

History & Objective: Congestive heart failure (CHF) is one of the most common diseases among children. CHF is important in pediatric medicine because of certain complications such as failure to thrive, recurrent respiratory infections, socioeconomic limitation, renal failure, and brain damages secondary to hypoglycemia and siezure. This study was done to recognize the ethilogy of CHF and to present a suitable ways for its prevention.Methods: The subjects of this descriptive study included 94 children under 13, being admitted at the pediatric ward of Shahid Beheshti Heart Center with CHF diagnosis during 1377. The diagnosis of CHF, done by a pediatric cardiologist, was based on the history, clinical manifestation, physical examination, and radiographic changes. Identification of ethiology was also based on clinical signs and physical examination, as well as echo cardiography, chest radiography and, electrocardiograph.Results: Data analysis showed the most common cause of CHF among subjects of the study were Congenital Heart Disease (CHD), especially multiple lesions (36%) and Atrial Septal Defect(ASD)(22%) with ASD and VSD complex being more common than other complexes. Discussion: Opposite to available literature this study showed that ASD was one of the most common cause of CHF among our patients. Since ASD is very common in this district early operation of such patients is of paramount importance.

History & Objective: Accidents have their own nature and follow the same epidemiological pattern as many other diseases. That is, the agent, the host and the environment intract together to produce injury or damage. They occure more frequently in certain age-groups, at certain times of day, or week, and at certain localities. This study is an investingation on frequency distribution of street vehicle accidents in Kermanshah in 1377. This destriptive- crossectional investigation has made use of available information in Kermanshah Traffice Police Department as well as available files in Medical Jurisprudence Organization of this city. Materials & Method: The variables of this descriptive study include: age, sex, kind of accident, drivers level of education, time, place, and the cause of the accident, weather conditions, human factors, mechanical defects which led to accidents, number of the injured and the dead along with. The age of the injured. The tolal number of accidents was 2334, which were divided into four main categories. 82% of the accidents were known to be compromise accidents. Then came accidents which led to injuries (10.9%). The third category of accidents were those which led to vehicles destruction (8.7%) and the last one are those led to death (0.2%). 99.7% of drivers were male. Most of the drivers (86.2%) were between 20 and 40 years of age (86.2%).Results: The highest rate of accidents was between 11 and 12AM and then are those between 4 and 6PM. Most accidents occurred on Sturdays and Thursday with the precentage rate of 17.31% and 16.37% respectively. Spring had the highest number of accidents (30.6%) in comparison with other seasons. Among 100 encoded places in the city most of the accidents occurred on Shahid Beheshti Bolvard (11.4%), then come Kordad 5 Square (5.3%) and.Discussion: Main reasons of accidents were disregarding the right of priority (31.4%), disregarding the appropriate distanc (25.4%), and sudden change of line (12%). Most of accidents happened in clear and dry weather condition (94.39%). Among 114 victims who were killed in car accidents in Kermanshah 99% were male, (86.84%). The number of people who were killed in car accidents was the highest in autum (39.47%).

History & Objective: Extranodal lymphoma is a subgroup of non Hodgkin"s lymphoma and its common primary sites are the head and neck (tonsilles), skin, and gastrointinal tract ( stomach and small intestine ). Primary Lymphoma in the female genital system, especially in uterine cervix is extremely rare.Patient: This is a case report of a 43- year old woman who referred to the hospital with the complaint of spotting. After primary work up including vaginal exam, pap smear, biopsy and pelvic sonography, the patient was admitted for abdominal hysterectomy. Pathologic results were compatible with lymphoma of uterine cervix. Results were confirmed with immunohistochemistry (IHC) method.Conclusion: Standard chemotherapy regimen for lymphoma and then radiation of pelvic and lymph nodes were done. Follow up of the patient did not indicate any problem. Although primary lymphoma of uterine cervix is rare and it requires special treatment with respect to the age and fertility status of the patients, it should be considered as a differential diagnosis of malignant lesions of uterine cervix.