Journal of Kermanshah University of Medical Sciences
Year:2006 | Volume:10 | Issue:3 (30)|Papers Count:17

Introduction: "Ghaze-yaghi" (Falcaria Vulgaris) is a plant from "Umbelliferae" family which has been used traditionally for skin wound healing in Kermanshah as dried powder. Since there have been less studies on the effect of this plant, this study has been done to see the effect of flacaria vulgaris on deep skin wound remodeling time and skin tension power in rats. Materials & Methods: This study was done on mature male rats in two parts. In first part dried powder of the plant was used as test and fiberglass powder as placebo and in second part alcoholic extract (5% and 10% in two separate groups) was used as test and ethanol 960 as placebo. After making the animals unconscious, two skin incision with 4cm length was made on the each side of vertebra column of rats. In the half of rats the right side and in the others the left side was selected as a test side and the other side as a control side. After making incision it was dressed with the plant and placebo for fifteen days. Wound surface was measured on third, sixth and sixteenth days. On sixteenth day a skin flap was provided and quantity of the skin tension power was measured and then flaps were sent to histological study. Results were analyzed with paired t-test. Results: In the first part the mean difference between the wound surface in test and control on hird, sixth and sixteenth days was significant (P.V=0.035, 0.008 and 0.002), but not for skin tension power. In the second part the mean difference between the wound surface in test and control sides in each rat for both two groups was significant (P.V=0.03, 0.001 and 0.03 for %5 extract and P.V=0.01, 0.001 and 0.03 for %10 extract).The mean difference between the skin tension power of the test and control sides in each rat was significant (pv: 0.02) by using 5% but not for 10%.There was no significant difference between test and controlled by histological study. Conclusion: "Ghaze-yaghi" has positive effects on the skin wound healing. It is recommended that more studies be done for finding the mechanism which makes these effects influential.

Introduction: According to the traditional use of falcaria vulgaris for gastric ulcer in the northwest of Iran, our pervious work showed protective effect of this vegetable on ethanol-induced gastric lesion. This study was designed to find out wound healing effect of hydroalcolic extract from falcaria vulgaris leaves on aspirin induced gastric ulcer in rats. Materials & Methods: 21 young male rats (NMRI strain), 190– 230g weight randomly divided into 3 groups; experimental, control positive and control negative (7 rats in each group). All animals had been exposed to starvation for 48 hours and then received oral ASA (200 mg/kg/day) in 1ml carboxymethyl cellulose 1% solvent for 3 days. The experimental group, received 150 mg/kg/day hydroalcoholic extract of falcaria vulgaris leaves (peculation methods), the control positive group received 200 mg/kg/day omeprazole and the control negative group received 1ml/kg/day distilled water for two weeks by gavages. Three hour after last treatment all animals were killed and stomachs were dissected. Number and length of ulcers determined using stereomicroscope and graticule and the ulcer index and curative ratio were calculated. Data were analysed using one-way ANOVA and Post-Hoc Tukey test. Results: Falcaria vulgaris extract (150 mg/kg/day) significantly decreased gastric ulcer index compared to control positive and control negative groups (P<0.01). Curative ratio in experimental group was significantly higher than the control negative 89.26%, and controls positive 87.79% groups. Conclusion: Hydroalcoholic extract of falcaria vulgaris showed significant effective wound healing in aspirin induced gastric ulcer in rats. Further studies in this field including human clinical trials are highly recommended.

Introduction: It has been reported that low serum ferritin level may increase risk factor of febrile convulsion. The aim of this study was to determine the level of serum ferritin in children with and without febrile convulsion. Materials and Methods: 40 children, 20 case with febrile convulsion and 20 healthy controls were studied. Case and control group were matched for age, sex and weight. CBC and serum ferritin was measured using previously described Elisa methods. Data was analysed using T- test. Results: Results showed that the mean Hb in case and control groups were 11.01± 1.12 g/dl and 11.85± 1.13 g/dl respectively. There was significant difference between case and control groups (p<0.05). The mean serum ferritin level in case and control was 47.5± 23.8 mmol/l and 57.8±37.5 mmol/l respectively and there was no significant difference between two groups. Conclusion: This study confirmed that the low serum ferritin level is not a risk factor for febrile convulsion and there is no relationship between low serum ferritin and febrile convulsion.

Introduction: Diabetic polyneuropathy is one of the most common and important complications of diabetes mellitus for its clinical ranking. Several clinical categorising scoring systems have been designated. Among them only Toronto Clinical Scoring System (TCSS) had been partially evaluated on the basis of pathologic findings in sural nerve biopsy. Only the mild cases had been studied since the myelin of sural nerve is destroyed in more severe cases of neuropathy and they are not appropriate for pathologic studies. This study was designed to evaluate TCSS on the basis of electro diagnostic findings in the mild to severe diabetic polyneuropathy in Kermanshah. Materials and Methods: 61 patients with diabetic polyneuropathy who have been referred to Clinic of Diabetes, were recruited and screened by using TCSS. In the next phase, nerve conduction studies measuring the amplitude and velocity of the sural, proneal, tibial, radial and ulnar nerves on both sides were examined in a single blind study. Nerve conduction abnormity index (NCAI) was calculated for each patient on the basis of the number of abnormalities in amplitude and velocity in these nerves. Correlation between TCSS and NCAI scorings were analysed using Spearman and Pearson co- efficient and the Kappa coefficient test. Results: 49 (80%) subjects were female and 12 (20%) male. The mean age for the female and male were 55±12 and 54±13 years respectively. 6 patients were IDDM and 55 patients were NIDDM. A significant correlation was found between TCSS and NCAI and (r=0.733, p<0.001) and (k=0.708, p<0.001). Discussion: A nearly direct correlation was found between the number of abnormalities in conduction studies and TCSS in diabetic polyneuropathy. In a previous study the correlation between TCSS and pathologic finding was shown in the mild diabetic polyneuropathy. We can recommend that TCSS is a valid scoring system for grading of diabetic polyneuropathy in clinical examinations. In addition, it is an easy method and suitable for clinical approaches.

Introduction: Several studies have shown the independent association of high plasma C-reactive protein (CRP) levels with adverse prognosis in patients with acute myocardial infarction (MI). The aim of this study was to assess the prognostic value of quantitative CRP (Q-CRP) to predict MI in patients with unstable angina. Materials & Methods: This cohort study was carried out between December 2003 & June 2004 in Tehran Heart Centre. 121 patients with unstable angina were selected. Q-CRP of these patients was measured and 10 mg/L considered as a cut-off point value for Q-CRP. Patients divided into two groups according to their Q-CRP cut-off value. Group A with QCRP _10 mg/L (n= 68) and group B with Q-CRP<10 mg/L (n= 53). All patients weremonitored for development of MI during the period of hospitalisation. The results were analysed to find out predictive value of Q-CRP in MI prognosis. Results: The mean age of patients was 60±7 year, 72 (59.5%) male and 49 (40.5%) female. Mean CRP value of participants was 14.42±7/3 (4-60 mg/L). MI was developed in four (5.8 %) patients in group A and in one (1.8%) patient in group B. There was no significant correlation between Q-CRP level and MI development (P>0.38). The sensitivity, specificity, positive and negative predictive values of Q-CRP in this study was 98.3%, 58.5%, 80% and 19.5% respectively.Conclusion: Although there was no significant correlation between Q-CRP level and MI development, in area with limited facilities, Q-CRP can be used for categorization of subjects with high and low risk of MI in unstable angina patients.

Introduction: In the literature Pica is reported to be prevalent in pregnant women, who, reported to have eaten substances that were clearly not foods but some thing which has been defined as “Pica”. Pica is an eating disorder, which may cause severe problems such as chemicals or heavy metals (e.g. lead) toxicity, intestinal obstruction and iron deficiency anaemia. This study was conducted to determine the prevalence of pica and its relationship with iron deficiency anaemia among pregnant women who referred to Community Oriented Medical Services of Kermanshah during 2001. Materials and Methods: After consecutive sampling, 300 pregnant women were recruited. Data, including age, education, parity, age of gestation, smoking, iron supplementation, having Pica during pregnancy and family history of Pica were collected via interview and questionnaire. Statistical analysis carried out using X2 and Fisher Exact Test. Results: In this study the mode age of women was 25.92 years. The prevalence of pica among the studied population was 22.3% and ice was the most common non-nutritive substance. Three women (4.47%) in Pica group were anaemic. There were significant correlation between Pica and education level and anaemia (p<0.005). However, there were no significant correlation between pica and parity, occupation, gestational age, iron supplement, smoking, familial history of pica and maternal age. Conclusion: As Pica is not limited to culture, sex or socio-economic and ethnic background it is necessary to raise public awareness of the adverse effects of this behavior. Primary health care staffs and dieticians should ask pregnant women with anaemia about pica and should counsel women who report pica regarding the health risks associated with it.

Introduction: Chlorine gas producting by mercury cell (chlor-alkali) is one of the most widely used methods. Leakage and vaporizing mercury from cells can cause occupational poisoning. Mercury is the most toxic non-radioactive heavy metal; therefore measurement of air concentration of this metal is very important. The aim of this research was measuring ambient air mercury concentration in an etrochemical company of Iran. Materials and Methods: This research was a descriptive-cross sectional study. Air sampling performed using OSHA ID 140 method. Absorbent tubes contain Hydrar (number 226-17-1A) were used to absorb air mercury vapour. Based on this method, a profiler (cellulose ester filter, size 0.8 um) was used to measure mercury particles size and the filter was analysed using OSHA ID 145 method. Air sampling performed in workshop, control room, up and down floor of cells in the plant and the numbers of samples were 8, 8, 12 and 12, respectively. Sampling performed from several sections of each unit throughout working time. Concentration during work shift was stable. Then preparation was analysed in 253.7 nm wavelengths by cold vapour atomic absorption spectrophotometer (UNICAM model 929). Results: Particulate air mercury concentration in workshop, control room, up and down floor of cells was 2.457±0.235, 9.945±0.930, 27.089±2.344, 18.745±1.016 mg/m3, respectively. Air vapour of mercury concentration was 46.685±3.653, 56.357±4.110, 81.267±2.818, 168.706±4.327 mg/m3 in workshop, control room, up and down floor of cells respectively. Because workers have been exposed to both type of mercury, the accumulative was carried out. Total mercury exposure in workshop, control room, up and down floor of cells were 49.143±3.882, 66.303±5.038, 108.357±5.034, 187.452±5.307 mg/m3, respectively. Conclusion: Threshold Limit Values TLV and Time Weighted Average (TLV-TWA) recommended air exposure value for mercury as 50 mg/m3 by NIOSH. This study showed that concentration of mercury in air was higher than recommended level in all units, apart from workshop area. Further researches need to be carried out to find health and clinical side effects of high mercury pollution exposed subjects.

Introduction: Brucellosis is one of the most common infectious diseases in some area of Iran. It has very different clinical sings and symptoms, thus it should be considered in differential diagnosis of most infectious and non-infectious diseases. Materials and Methods: 415 Brucellosis patients, who referred to Imam Khomeini and Sina Hospitals of Tehran during 1998 to 2005, were studied from epidemiological, clinical, laboratory and treatment protocols aspects. Results: 52.5% of patients were female and 47.5% male with mean age of 35.5 years old. 84.3% of subjects were living in urban and 15.7% in rural area. The commonest transmission way was consuming of contaminated dairy products however 17.1% of patients had history of animal contact. The most contagious seasons were summer and spring. Family history of brucellosis was positive in 19.51% of the patients. The most common symptoms were fever (67.22%), sweating (73.25%), malaise and fatigue (65.45%), arthralgia (29.15%), headache and coughing. Whilst the most common clinical signs were fever (56.62%), peripheral arthritis, sacroilitis and splenomegaly. CBC analysis showed normal range in majority of subjects. Although doxycycline and Rifampin were the most common prescribed medicines combination of cotrimoxasule and doxycyline showed more efficient effects to control the diseases.Conclusion: Regarding variable clinical presentations, brucellosis should be considered in differential diagnosis in subjects with chronic fever or chronic fever plus other organs abnormalities.

Introduction: Coronary artery disease is one of the most dangerous health problems in developed and undeveloped countries. Annually one million patients admitted in coronary care units in U.S.A due to AMI and about 59 million people suffered from Atherosclerosis. In Europe 54% of C.C.U admissions is due to non Q wave MI and 46% due to Q wave MI. Unfortunately there is no distinct statistic al results concerning the incidence of acute coronary syndrome in Iran. Materials and Methods: This study was carried out to determine prevalence and incidence of acute coronary syndrome during 2002 –5 in Imam Ali Hospital of Kermanshah. Calculated sample size was 621 patients, of whom, all clinical and demographic data were collected. _2 and T-Test were used to analyse the data. Results: 843 patients profiles were studied, 607 males and 236 females aged between 25 to 78 years old. The study showed; 312 patients with unstable angina, 453 patients with Q wave myocardial infarction and 78 patients with non-Q wave myocardial infarction. Incidence and prevalence of acute coronary syndrome were U.A 37%, non-Q wave MI 9.2% and Q wave MI 53.7% respectively. Conclusion: More different incidence and frequency of A.C.S was observed than those reported by developed countries (e.g. 9.2% non Q wave MI vs. 54%). Further studies needed to be done to find different prevalence of ACS in Kermanshah.

Introduction: Working in hospital as a Health Care Worker (HCW) predisposes the staffs to the risk of tuberculosis infection (TB). Majority of hospitals around the world have developed protocols to prevent their personnel against TB. This study was carried out to determine the status of TB prevalence in the HCWs using tuberculin skin test to establish an occupational health protection against TB in exposed HCWs during their employment. Materials and Methods: All 437 HCW personnel of Imam Khomeini Hospital of Kermanshah were invited to take part in the study in 2004. Tuberculin skin test performed and results were observed after three and six days. The subjects with tuberculin negative results, PPD induration less than 10 mm, were tested again after 10 days and the results were observed after three days. X2 and Fisher Exact Test were used for data analysis. Results: 318 (72.8%) HCW personnel, 130 (41%) women and 188 (59%) men, agreed to participate in the study. Mean age was 37.4 ± 8.67 years old and mean employment duration in the hospital was 13.5±8.51 years. 163 (51.3%) of participants had positive PPD result, of whom 161 subjects developed PPD positive result within first test and only two subjects observed positive PPD result in the second test. There was no observation of delayed tuberculin hypersensitivity. The frequency of booster effect was 2.3%. The highest and the lowest rates of PPD positive were seen in laboratory and emergency units (66.7% and 28.6% respectively). There was a positive statistical relation between age and duration of employment and positive PPD result (p<0.001). Prevalence of positive PPD was significantly lower in women than men (p<0.004). There was no significant difference between subjects with and without history of B.C.G vaccination and PPD positive results even in PPD induration size more than 5 mm. Conclusion: HCWs employed at Imam Khomeini Hospital of Kermanshah are at substantially increased risk for TB, suggesting significant risks from infected patients’ transmission. Control of hospital spread of TB in Kermanshah which is an area that requires urgent attention, is necessary. Introducing health care profile and periodic PPD tests, which may help to earlier diagnosis of infected HCWs with effective chemoprophylaxis to prevent them from TB, are highly recommended.

Introduction: Amblyopia is reduced vision in an eye that has not received adequate use during early childhood. The most common cause of unilateral visual loss in children is amblyopia with prevalence rate of 1-4 percent in pre-school children. However, effective treatments may prevent intensive complication. This study was done to assess the treatment effects of amplyopia patients who have referred to Imam Khomeini Hospital of Kermanshah during 1998 to 2000. Materials & Methods: This study was a descriptive interventional before and after assessment. 56 amblyopia-diagnosed patients (86 eyes) with visual acuity less than 9 out of 10 referred to clinic of optometry were selected. In this research tools such as: ophthalmoscope, filter visioscope, dial astigmatic, prism bar, madoxwing, Snellen chart, titmus test and ischihara chart were used for diagnosis. Ophthalmologist performed amblyopia diagnosis and optometrist carried out treatment. Treatments included visual training, bleaching, part time patching, and full time patching and in some cases penalization carried out and descriptive & inferential statistics were used to analyze the data. Results: There were 58.5 percent refractive amblyopia, 10.9 percent strabismic, 7.3 percent deprivative and the rest were involved by mixed problems. The difference rate of steriopsis between after cure and before cure was 329.09 ±253.90 seconds figured by titmus stereo test. The average of visual acuity before and after treatment was 20/60 and 20/30 respectively. Conclusion: The results of this study showed that the considerable improvement was observed in amblyopia eyes with increased vision acuity about 3 lines in Snellen chart after curing the patients. We can conclude that treatment and curing of amblyopia may have good results. The earlier the treatment, the better the opportunity to reverse the vision loss. If not treated early enough, an amblyopic eye may never develop good vision and may even become functionally blind.

Introduction: The main reason for choosing cesarean delivery is to save the life or health of the mother and her baby. However, cesarean is not without complications, either for the mother or the baby. It is well documented that cesarean rate in Iran is higher than other developing countries and mother’s request reported the main influencing factor. This study carried out to find the relative frequency of the reasons of choosing cesarean among women who referred to the Bea’sat Hospital of Sanandaj during 2004. Materials and Methods: 60 women who had undergone a cesarean delivery based on their own request recruited. Data was collected through face-to-face interview. Results: An average age of subject was 28.4 years and 60% of them had an academic degree. 78.4% had no previous delivery history and more than 50% of the participants have been under supervision of both national and private medical services. 80% had not received any training in delivery methods. More than 50% of the subjects had persisted their physician to perform the cesarean delivery. The most common reasons for choosing the cesarean were fear (48.3%) and unpleasant feeling of risk or danger for baby (18.3%). Fearing delivery pain and lack of alleviative measures were the most common reasons for Cesarean. Physician recommendation (13.3%), belief in limited facilities and educational environment of hospital were the other reasons for choosing cesarean. Conclusion: It can be concluded that increasing knowledge of pregnant women through primary care education system and applying proper methods of pain relief with promoting them to select normal delivery may decrease cesarean rate. Further research in different age and socio economic groups with more details are recommended.

Introduction: Acute renal failure is an uncommon complication of idiopathic nephritic syndrome in children. Renal failure could be secondary to causes such as sever hypovolumia, acute tubular necrosis, interstitial nephritis, bilateral renal vein thrombosis, acute pyelonephritis and rapid progression of original glomerular disease. It may be idiopathic if the underlying cause is undetermined. Although idiopathic acute renal failure (IARF) has been described previously, this study presents histopathologic finding and outcome of IARF in a child with idiopathic nephritic syndrome. Case Report: An 11 year - old girl with corticosteroid and cyclophosphamid resistant nephritic syndrome presented with acute renal failure. She was on cyclosporine one year ago but had relative response to cyclosporine, which presented with irreversible acute renal failure. Discussion: IARF is a rare complication in children with idiopathic minimal change nephritic syndrome. The exact pathophysology of IARF is not well understood. Possible proposed explanations included severe interstitial oedema, peritonitis, hypovolemia, tubular obstruction, and altered glomerular permeability. In this case there is no justifiable cause for acute renal failure and IARF should be considered as a diagnostic possibility in this patient.