Journal of Kermanshah University of Medical Sciences
Year:2010 | Volume:14 | Issue:3 (47)|Papers Count:18

Background: The common detoxification method is replacement of long effect opiate by short effect opiate and then reducing its amount gradually. More modern method is ultra rapid opiate detoxification (UROD) by opiate antagonists, which is performed by general anesthesia. The advantages of two methods have not been confirmed. This study aimed to compare effectiveness and withdrawal rate in both methods following up to a year.Methods: 211 self-introduced patients who referred to Farabi hospital for withdrawal were enrolled in this cross sectional study during 2005-06. The patients underwent detoxification after psychiatry screening and addiction confirmation. They divided into two detoxified method groups (110 patients in UROD and 101 Methadone). Recurrent and suspected cases were confirmed or rejected by urinary test and more specific test respectively. Data was collected from available patients profiles and contacting with patients or their relatives and was analyzed using Chi-square & independent sample T-test.Results: The results showed that addiction recurrent in UROD and Methadone groups was 35.7% and 56.4% respectively (P=0.002). The average age of recurrent subjects in UROD group was younger than successful population at that same group (27.95±5.2 vs.31.4±7.1 years old, p=0.008).Conclusion: This study suggested that chance of detoxification and successful withdrawal by UROD method is higher than Methadone method and younger patients are more likely to get the recurrence. It is recommended to compare these two methods in a prospective study by unifying both groups based on age and considering opiate use duration.

Background: Polychlorinated biphenyls (PCBs) are toxic bio-accumulate components and may increase risk of adverse effects on human health and the environment. For different social, technical and economic reasons, significant quantities of PCBs contaminated transformer oil are still in use or storied. The study aimed to determine the effect of hydrogen peroxide and solvent on photolysis of PCBs to reduce occupational exposure. Methods: The photochemical annular geometry (500 ml volume) reactor was designed with a cylindrical low-pressure mercury lamp (UV-C Cathode on TUV 6WE) with emission at 254 nm. The radiant power emitted by the lamp was 6w. The whole lamp was immersed in a reactor thermostat controlling of temperature at 32±2 oC. The PCBs was determined using GC/ECD and data was analyzed by SPSS.Results: Degradation of total PCBs in terms of %10 and %20 of volume of H2O2 were 41%, 75% and 94%, respectively. The degradation of total PCBs in terms of ratio to solvent with oil transformer in 1: 1, 2: 1 and 3: 1 was 61%, 75% and 94%, respectively.Conclusion: Our study show that UV-C photolysis of H2O2 leads to a degradation efficiency of PCBs only in the presence of isooctane, therefore indicating that the intermediates formation after ethanol oxidation are able to initiate PCBs degradation.

Background: NO2 is a poisonous gas that potential to cause major threat to human being health and the environment, as a result, removing this gas from environment seems to be essential.Methods: The study aimed to remove this gas from environment using Iranian natural zeolite, clinoptilolite. After crushing and preparing two sizes of 1 and 2 mm zeolite they were activated in 380 to 420 oC for 20 minutes. NO2 was produced by reaction of copper (Cu) and nitric acid (HNO3) and diluted with enough air to achieve desired concentration. A laboratory reactor set with different concentration of NO2 (20, 30, and, 45 ppm), flows through the zeolite absorbent bed was prepared. Different parameters affected No2 absorption, such as concentration, height, and diameter of zeolite bed, zeolite granulation, and activation temperature were examined.Results: In different condition, the adsorption range of the zeolite for NO2 was varied from 0.35% W for 2mm granulation and the 20 ppm concentration to 1.5% W using 1mm granulation and 45 ppm concentration of NO2. Activation temperature of 420 oC for 20 min was the best condition removing NO2. Efficiency of 1mm granulation was higher than 2mm.Conclusion: Reducing parameters such as height and diameter of zeolite bed decreased but increasing concentration of gas flow increased adsorption capacity of zeolite. Using Iranian zeolite in gas masks still not recommended.

Background: Unripe cervix is one of the most causes of failure of labor induction. There are different methods for labor induction, which may differ depending on its duration. This study was performed to compare the effectiveness of vaginal Misoprostol intravenous and Oxytocin for induction of labor on hospitalized patients. Methods: In a randomized clinical trail 110 pregnant women with Bishop score...

Background: The aggression is one of the most important problems among the adolescences in relation with the others. Aggression is an emotion and researches showed that the emotional intelligence might help to better manage. The purpose of this research was to investigate the effectiveness of the emotional intelligence training on the aggression.Methods: An experimental design was conducted using pre and post-test including control group. The statistical population included 420 adolescent boys. 120 students were selected and asked to complete Boss and Perry’s aggression questionnaire. 30 students who have got highest scores were selected and randomly divided into two the experimental and the control group. The experimental group received eight teaching sessions of the emotional intelligence training while the control group did not. At the end the aggression questionnaire completed again. The collected data were analyzed using covariance and t-student test.Results: The results showed that the emotional intelligence training decreased the physical, verbal and anger aggression. There was not changed in the level of the student's hostility.Conclusion: We can confirm that the emotional intelligence training may reduce aggression in adolescent boys. Introducing emotional intelligence training in the national educational system for secondary school boys highly recommended.

Background: Traumatic birthing mothers may expose more susceptible to experiences posttraumatic mental disorder such as anxiety. This study aimed to determine the effect of midwifery counseling intervention on the anxiety level after traumatic childbirth of primiparous women. Methods: In a randomized control trial 180 woman who had experienced traumatic childbirth based on DSM-IV criteria have been selected. The subjects were randomly divided into an intervention (n=90) and control (n=90) groups. The intervention group received midwifery counseling during two sessions and control group just received routin health care after childbirth. Both groups were followed up with partial – blind technique and compared 4-6 weeks and 3 months post partum. The data were analyzed using descriptive statistics by SPSS software. Results: Demographic characteristics, pregnancy complications and social support level were the same in both groups. In addition, there was no significant difference between two groups according to stress, depression and anxiety level before intervention (P>0.05). There was significant difference between two groups in anxiety level after 4-6 weeks and 3 months followup ...

Background: Brief family interventions may have a positive impact on family caregivers of mental disorders. This study aimed to evaluate the effect of family psycho-education on depression, anxiety and stress in family caregivers of patients with mental disorders.Methods: This randomized controlled trial designed and evaluated the effectiveness of a group psycho-educational program on 100 caregivers of mental disorders attending in Noor hospital in Isfahan. The caregiver’s depression, anxiety and stress level was assessed using the DASS scale. The participants followed up for a period of three months.Results: Depression, anxiety and stress level decreased significantly in the psycho-educational group. The mean score of the DASS scale in the intervention group was significantly reduced compared to the control group.Conclusion: Our findings confirmed that group intervention program for reducing depression, anxiety and stress levels in Iranian population was effective and may potentially improve the quality of life of both patients and caregivers.

Background: Sleeping disturbances considered as a remarkable health problem among shift workers, which may lead to physical and mental disorders. This study aimed to examine the sleeping quality and its relationships with the general health among shift workers in a metal press workshop.Methods: Descriptive study was conducted and assists 196 subjects of shift workers who were working in press workshop in a car industry. General Health Questionnaire (GHQ-28) and Pittsburg sleep quality Index (PSQI) was used. In addition, some information was collected through interview in the workplace and was analyzed by Fisher and Chi-Square statistical tests.Results: findings suggest that undesirable general health status and poor sleep quality rates were 36.7% and 50% respectively. Statistical tests showed significant associations between sleeping quality and general health ...

Background: Prevalence of gestational diabetes (GD) varied between 1-14% around the world. Such variation in the prevalence of GD as well as no available information in Kermanshah encouraged us to design this study aimed to investigate about prevalence of GD and factors associated with this condition in Kermanshah.Methods: A cross-sectional descriptive analytic study was designed. The study population was 1720 pregnant women referred to Kermanshah's primary health and treatment centers. All recorded information within their profiles including demographic data, last pregnancies, familial history, result of GCT and OGTT (if data were available) was collected. Data were analyzed using univariate and multivariate statistical methods (logistic regression).Results: Prevalence of GD cases was 3.43%. Diabetic mothers were more obese and older than non-diabetic mothers and greater proportion of such women had previous history of GD, still birth, familial history of diabetes, history of abortion, macrosomia and PCO. In multivariate analysis showed that age, obesity, familial history of diabetes, previous history of GD and abortion increased the risk of GD. Conclusion: The prevalence of GD in Kermanshah is comparable with other studies in Iran. Controlling related risk factors may reduce risk of GD.

Background: Ovarian cancer is a relatively common cancer among postmenopausal women. Nowadays, there is controversy about immunotherapy of ovarian cancer patients with interleukins such as interferon to reach better out come in prognosis of patients under chemotherapy. CTLA-4 is a gene, which has an important role in homeostasis and regulation of immune response. Inhibitory nature of CTLA-4 is proved to be of significance in autoimmune diseases as well as in cancer. In this study we intend to find out the relationship between polymorphisms of this gene at the sites of+49 A/G and -318 C/T and ovarian cancer.Methods: The polymorphisms of the CTLA-4 gene at the sites of+49 A/G exon and -318 C/T promoter were investigated. Blood samples of 73 patients with ovarian cancer and 115 healthy subjects used for DNA extraction Two groups genotypes and alleles were determined using PCR method and compared by statistical t-student test.Results: There was no statistically significant difference in genotypes and alleles prevalence of+49 A/G and -317 C/T between two groups (p>0.05).Conclusion: Further researches with larger sample size while paying attention to the relation between the gene polymorphism and stage and type of tumor is recommended.

Background: Choledochal cyst is a congenital disorder of biliary tract. It is rare in western but more common in Asian countries. Most studies have been case reports but in this study for assessment of surgical method of treatment and late complications, patients were followed for 18 years. Methods: This retrospective study was done based on 23 patients profiles with diagnosis of choledochal cyst who have been admitted in two hospitals, Mofid and Taleghani in Tehran during 1986-2004. Diagnosis was based on imaging and intraoperative findings variables for assessment were age, sex, cyst type, clinical picture and surgical method of treatment.Results: 70% of cases were female. Type I (sacular and fusiform, 74%) was the most common type, 70% of cases were between 1-5 years old, sonography was the most common imaging technic, that used for diagnosis (100% of cases), Icter was the most common clinical picture found in 70% of cases, surgical procedures and method in 70% of cases was standard and 30% of patients underwent palliative procedures.Conclusion: Although this study shows similarity in age, sex, common type, diagnostic and treatment methods with another centers and countries, but it shows necessity of surgeon’s encouragement to use standard surgical method for decreasing late complications of disease.

Background: Sildenafil is a selective inhibitor of phosphodiesterase type 5 (PDE5) which currently used for the treatment of erection dysfunction (ED). Medicine approved by the FDA for treatment of pulmonary hypertension. Although there is no evidence of hyper coagulation states being associated with the use of PDE5 inhibitors, several animal studies suggest that PDE5 inhibitors may cause arterial and venous thrombotic or embolic events. Case report: The patient was a 37 year old man who had suffered sever headache and tonic- clonic generalized seizure. In neurological examination, he had decreased level of consciousness and he had no other positive finding in examination. The patient has been constantly taken 100 mg of Sildenafil once a day without medical supervision over the last month. Brain computerized tomography (CT) showed a small hemorrhage in left frontal lobe with suspicious to cerebral venous sinus thrombosis (CVST) lumbar puncture was performed. Increased cerebrospinal fluid pressure suggested the probability of CVST. Brain MRI result confirmed superior sagittal sinus thrombosis. Conclusion: Cerebral venous sinus thromboses need to be considered a potential side effect of Sildenafil administration.

Annually many numbers of pationts with Cutaneous Leishmaniasis (CL) have been reported in Kermanshah province- IRAN. The study aimed to identify species of Leishmania isolated from patients with CT in Kermanshah. Seven isolates of Leishmania obtained from patients with CL, without any travelling to other provinces, were cultured in NNN medium. After mass production of leptomonads in RPMI 1640 medium DNA was purified and the species were diagnosed using RAPD-PCR technique. The study of electrophoretic fingerprints of the product of RAPD-PCR in seven isolates showed that Leshmania major was the causative agent of CL patients in Kermanshah province. More studies in this field recommended.