Journal of Kermanshah University of Medical Sciences
Year:2002 | Volume:5 | Issue:3|Papers Count:12

History & Objective: Iran is one of the endemic regions of cutaneous leishmaniasis (CL) in the world. Due to lack of information about conditions in numerous CL foci in this country, the present study was aimed to find out the prevalence of CL in Booshehr province between 1362 and 1378.Materials & Methods: The data of this descriptive study included the existing data regarding the prevalence of CL in different seasons, years and districts which were reported to Booshehr's Provincial Health Center between 1362 and 1378. Results: The analysis of the collected data revealed that Booshehr province is one of the Endemic foci of zoonatic cutaneous leishmaniasis (ZCL) caused by leishmania major. The study also showed the rate of CL indicence during these 17 years had not been fixed and fluctuated from time to time (with the general rate of 1.75 per thousand). At least two important epidemies in 1367 and 1376 with prevalence rate of 5.25 and 6.57 per thousand can be identified in this period. It was also evident that the highest rate of incidence of CL was in fall and winter, which is one of the most important characteristics of ZCL.Discussion: Occurrence of two important CL epidemics in Booshehr province, which is supposed to be one of the endemic foci of this disease, in the period of 17 years, can clearly show the importance of introduction of special preventive and controlling programs by the health officials in the province.

History & Objective: Considering the prevalence of placental retention and it's potential danger, this study was conducted to find the factors of impacts on placental retention among pregnant women referred to Motazedee Maternity Hospital in 1996.Materials & Methods: The subjects of this case-control study included 50 of 500 women with normal vaginal delivery and placental retention. 50 other women who matched the first group except for placental retention were put in another group (control group). The data which included information about preterm delivery, previous cartage, and previous placental retention, agent of delivery, placental questionnaire, pariety and method of placental extrusion was collected through a questionnaire. The data was analyzed by T-student, X2 and Odd's Ratio.Results: Analysis of the data showed preterm delivery was significantly higher in placental retention group (P< 0.004). Similarly, there was a significant difference between the two groups with respect to previous cartage (P<0.04). In 60% of deliveries, widwives were known to be responsible for placental retention. Regarding pervious and current placental retention, the groups revealed a statistically significant difference (P<0.03); however no significant difference was seen between two groups with respect to parity. Placental from played a more important role in placental retention group (P<0.005).Discussion: The study showed factors such as preterm delivery, previous, cartage, previous placental retention, agent of delivery and placental from play important roles in placental retention. Since bleeding is the most dangerous complication of placental retention, appropriate management in the 3rd trimester by agent of delivery can shorten this period and prevent early bleeding. Further studies are needed to have a better understanding of the issue.

History & Objective: Considering the relation of recurrent laryngeal - nerve with the inferior thyroidal artery and their impacts on thyroid gland surgery, the present study was designed to study both the structural and anatomical changes of the thyroid gland in 100 cadavers in Tehran's Legal Medicine Center from 1994 to 1995. Materials & Methods: The data of this descriptive study included information about: weight- length, width, and isthmus of thyroid gland. Further information about thickness of capsule, the condition of the inferior laryngeal nerve with respect to nearby structures and the condition of the superior laryngeal nerve was collected. Results: Analysis of the data showed 26 of the cases was females and 74 were males, between 20 and 65. The average weight of thyroid gland was 21.9±4.49 gm. The average length and width of each lobe were 5.26±0.46 and 2.60±0.46 respectively. The average length of isthmus was 1.04±0.18cm. In 7% of the cases, the recurrent laryngeal nerve passed through branches of the inferior thyroidal artery (4% on the left & 3% on the right). In 42%, the nerve was on the right and in 27% on the left, passing in front of inferior thyroidal artery. Recurrent laryngeal nerve in 59% of the cadavers was on the left and in 55% of them was on the right, passing through Berry ligament. Discussion: This study indicated that the dissection of the recurrent laryngeal nerve in the surgery of thyroid gland protects this nerve from damaging. Since recurrent laryngeal nerve innervate all muscles except the Cricothyroid gland muscle, any damage to this nerve will stop the larynx from functioning and impaires the activity of the vocal cards on the affected side. Findings the exact location and path of the recurrent laryngeal nerve can minimize the damage to it.

History & Objective: Considering different types of ovarian masses and lack of enough information in this regard, the present study was carried out to determine the most common types of ovarian masses in patients admitted at Motazedi Hospital in Kermanshah between 1997 and 2000.Materials & Methods: This study was based on the records of the patients who had been operated at Motazedi Hospital and were diagnosed with ovarian masses. Information about patient's age, type of mass, pathology results, as well as clinical manifestation such as: anorexia, weight-loss, weakness and' fatigue, urinary and gastrointestinal symptoms, vaginal bleeding, constipation and diarrhea, respiratory discomfort, nausea, vomiting, and ultrasonography results were carefully recorded in special forms. The collected data was then analyized by descriptive methods. Results: Analysis of the result showed 55% of 178 cases had non-neoplastic masses and 45% of the masses were diagnosed as neoplastic. It also became clear that the most frequent type of masses among non-neoplastic cases were luteal masses (86.7%), while the most common neoplastic masses were epithelial tumors (67.5%). Most patients in non-neoplastic group (54%) and neoplastic group (45%) were between 20 and 34. But as the age increased, the percentage of neoplastic masses was increased, too. Abdominal pain was the most common symptoms among patients in both non-neoplastic cases (57.3%) and neoplastic cases (66.3%).Discussion: In the light this study it became clear that benign ovarian masses are more frequent than malignant ones. Ofeaurse, of course further studies with respect  to factors such as the number of deliveries and impacts of contraceptive pills can give us better understanding.

History & Objective: Considering the high prevalence of knee deformity and its debilitating complication as well as its expensive treatment, the present study was aimed to determine the prevalence of knee deformity in Kermanshah during 1378.Materials & Methods: The subjects of this descriptive study included 8457 cases who were randomly selected from 100000 residents of Kermanshah Community Oriented Medical Education Center. A team of two physicians along with a family health worker examined the subjects with respect to their general health status and clinical knee deformity at their homes. Afterwards, separate check-lists were filled out for each. The collected data was analyzed by X2-test.Results: Comprehensive analysis of the collected data indicated that 53% of the subjects had knee deformity. It also became clear that prevalence of knee deformity among male and female subjects under 7 was 17%. Meanwhile 64% of subjects over 11 showed sing of knee deformity (with sex. distribution of 72% females and 54% males) which is insignificant statistically.Conclusion: Comparison of the results of the present study with those carried out in other parts of Iran showed prevalence of knee deformity in Kermanshah is lower than other provinces.

History & Objective: Noise is one of the adverse physical agents in industries, specially in power plants. As such, this research was aimed to study noise pollution in Bisotoon power plant in 2000.Materials & Methods: The present study is a cross-sectional descriptive research which was aimed to determine the noise levels in different units of Bisotoon power plant. For this purpose, the area of the site was divided into 2x2 meters squares according to ISO and NIOSH methods. The center of each square was considered as a measuring point. Afterwards, noise level in two networks of A and C along with its Max mode were measured by calibrated QUEST-2800 sound-level meter in two seasons of summer and winter.Results: Analysis of collected data indicated the noise in the power plant was of a low-tune type which was mostly in frequencies of more the 500 Hz. It also became clear that noise level in most units of the power plant was higher than 90 dBs (which is higher than NIOSH standard, based on z test with cl of 95%). The study also showed the noise level in certain periods of time was so high that according AGGIH standard expurse of more than 15 minutes with such noise could affect workers health adversely. Noise level in different places around the site was 80 and 79 dBs in summer and winter respectively.Discussion: This study suggests that noise pollution is a serious problem in Bisotoon power plant. However, introducing safty measures and conducting successful health Programs along with woken's regular medica check-up, and better maintenance of Existing machinery will definitely help us to eradicate or us to least reduce the adverse Effect of the noise pollution in the area.

History & Objective: Refractive error is a common cause of visual inacuity all around the world. The purpose of this study is to determine the prevalence of refractive errors and detect new cases among students in Kashan between 1376 and 1377.Material & Methods: The subjects of this descriptive study included 4236 students who were tested twice. In the first stage students were tested on their perception of letters on Snellen chart which was in the distance of 6-meter. After determining the type and degree of the refractive errors, the cases received certain drugs for treatment. Meanwhile, information about type and degree of refractive errors along with information about cases sex, age, history of using eye-glasses and history of refractive errors in their family were recorded in special forms which were, later, analyzed statistically.Results: Analysis of the collected data indicated that among 4236 (16.2%) of the total population of the study (39053) who were tested in the first stage 49.3% were female and 50.7% were male. 39.2% of the subjects studied at primary schools, 2.5% at guidance schools and the rest (32.3%%) went to high schools. The study showed 21.5% of the students (911 cases) had visual acuteness of less than 8/10 (24.3% female and 18.9% male). 462 subjects (16.9%) had refract we errors; 72.3% suffered from myopia, 20.5% had compound myopic astigmatism; while, 6.3% of them showed simple astigmatism and 0.87% suffered from hypermyopia. 55.7% of myopic cases had positive history of refractive errors and 12.5% of them had less than 8/10 visual acuity which hadn't been diagnosed previously. Discussion: The number of cases with less than 8/10 visual acuity, specifically those who were not aware of their problems was comparatively high and myopia was quite common. Further studies are needed to get a better undemanding of the situation in Iran.

History & Objective: Pneumonia is very common among children with Congestive Heart Failure (CHF) and any delay in its diagnosis and treatment can have serious outcomes for patients. Due to the lack of information in this regard the present study was aimed to determine the prevalence of pneumonia in children with CHF in Kermanshah.Materials & Methods: In this descriptive study, diagnosis of CHF, and pneumonia was strictly based on the existing standards. After distinguishing all clinical and preclinical signs which differentiated CHF sufferers with pneumonia from those who merely suffered from CHF, the prevalence of pneumonia was closely studied. Results: Data analysis indicated among 64 children with CHF who were admitted at the hospital, 46 (72%) patients suffered from pneumonia. The prevalence of pneumonia in CHF sufferers under 1 was 80%. However, as children grew older this percentage decreased. Comparison of the two groups of CHF patients with pneumonia and CHF patients without pneumonia showed statisically significant differences. 78% of CHF sufferers with pneumonia experenced wheezing while only 22% of the patients in the other group showed such a sign (p<0.0005). Similarly 91% of CHF patients with pneumonia had breathing distress, but this figure for the other group was 66% (p<0.02). The increase in the number of lococytes was also detected in 88% of CHF patients with pneumonia; however, 50% of the children in the other group have an increase in the number of lococytes. 67% of pneumonia cases were in the left to right shunts and 23% in the cardiomyopathy. Other conditions seemed to be accompanied with CHF were: mitral failure, tetralogy of Fallot, coarcation of aorta and tricuspid artesian. 10% of children with CHF and Pneumonia, who was mostly under 1, lost their lives.Discussion: Reducing the high prevalence of pneumonia in children with CHF and finding new ways for its prompt diagnosis and treatment is of paramount importance nowadays. Further studies can definitely open up new horizons to reduce the death toll of this disease specifically among infants and young children.

History & Objective: Clinicians must be knowledgeable about herbal preparations and their toxic syndrome. In this paper five cases of poisoning with Salmah- Tarah are reported. Salmah-Tarah (chenopodium-album) is a weed growing in all part of Iran as well as in Kermanshah. This herb contains some phototoxin that can cause photosensitivity and skin lesion (dermatitis) in people who eat it and exposed to sun. The aim of this study is to report five cases of herbal poisoning with Salmah- Tarah. Patients with dermatitis may have herbal poisonig. Patients: After taking an herbal preparation all five cases Salmah- Tarah became ill.These patients showed a photosensitivity reaction with edema, pupules, vesicules, bulla and ulceration in exposed areas. Conclusion: This study showed that people should be warned against PQ toxicity of herbal medicine. Furthermore, dermatologist must also be fully aware of herbal poisoning with Salmah-Tarah.