Journal of Kermanshah University of Medical Sciences
Year:2005 | Volume:9 | Issue:2|Papers Count:9

Introduction: Vesico-Urethral Reflux (VUR) is the most common complication of Urinary-Tract Infection (UTI). Detecting VUR has been classically achieved by Voiding Cystourethrography (VCUG). Radionuclide cystography will detect VUR, but fails to provide the same detailed anatomical information as VCUG. This study designed to compare the IRC and VCUG.Materials & Methods: This study has been done on 55 patients suffering from UTI admitted in Razi Hospital of Kermanshah during 2001-2. They were evaluated by two methods (VCUG and IRC), which were performed apart from each other during one month for each patient. Results: From 55 patients 69% were females and 30.9% were males. The age range of patients was 6 months to 13 years. From 109 renal units VUR was detected by cycling IRC in 29 patients (26.4%) while in 15 patients by VCUG (13.9%).Conclusion: The result of this study indicated that IRC had a higher sensitivity in comparison with VCUG technique. So it is recommended that the IRC Method be used in diagnosing Vesico Urethral Reflux.

Introduction: Cerebral autoregulation (CA) and Mean Cerebral Blood Flow Velocity in males and females are still under controversy. The present study was scheduled to address the effect of sex on these parameters.Materials and Methods: The Present study was interventional and performed on 30 healthy volunteers (15 males aging from 20-30 yrs and mean age of 23.9±3 years old and 15 females aging from 20 to 30 yrs and mean age of 24.2±2.5 years old). Flow velocity in middle cerebral artery (MCA) was assessed using transcranial Doppler (TCD) ultrasonography with a 2MHz probe. Eckbergs neck suction device was utilized to stimulate carotid baroreceptors and a standard electrocardiograph, which recorded lead II ECG traces, demonstrated carotid baroreflex response. In this study mean blood flow velocity in MCA represented the amount of brain blood flow. To analyze the data ANOVA and t-test were employed. Results: There was a significant reduction in the heart rate after carotid baroreceptors stimulation in both sexes (P<0.001). The difference between the mean blood flow velocity oscillations of both groups in MCA during carotid baroreceptors stimulation was not statistically significant. However this was significantly higher in females both in baseline state and during stimulation (P<0.05).Conclusion: The results indicated the high efficacy of cerebral blood flow autoregulation and higher cerebral blood flow velocity in females which is probably due to estrogen hormone.

Introduction: Standard dose regimens for eradicating Helicobacter have side effects, so some patients are not able to continue their treatment. This study was done to evaluate two regimens of tetracycline and metronidazole in eradicating Helicobacter Pylori with particular attention to frequency of side effects of two therapies.Materials & Methods: A prospective randomized controlled trial was conducted on 90 patients with peptic ulcers who were positive for H. pylori. Subjects were divided into two equal groups (low dose & standard dose tetracycline groups). They were matched for age, sex and type of ulcer and received a two week course of either tetracycline 500 mg and metronidazole 250mg every 6 hours per day or tetracycline 250mg and metronidazole 125mg every 4.5 hours per day. Both groups received ranitidine 150mg two times per day. H. pylori status was determined endoscopically by Urease Test. Standard questionnaire was administered to determine compliance to treatment and side effects and to analyze the data t.test was employed.Results: H.pylori was eradicated in 26/39(66%) in standard group and in 28/45(62%) in low dose group (P>0.05). Side effects were less frequent and less severe in low dose group (p<0.001).Conclusion: From the above results we can conclude that low dose is more efficient and is accompanied by fewer and milder side effects in comparison to standard dose.

Introduction: Factors like Preparing pediatric patients for anesthesia and surgery, separating them from parents, peculiarity of operation rooms and painful procedures such as injection usually produce anxiety and lack of cooperation in children. Oral premedication with a sedative, anti-anxiety drug which has no major side effects can response to these challenges.Materials and Methods: In this double-blind experimental study 120 patients ranging from 9 months to 7 years were selected by simple sampling in Taleghani Hospital of Kermanshah. They were allocated randomly in two groups (group A with 60 cases received 6 mg/kg Ketamine dissolved in 0.5cc/kg clear fruit juice and group B with 60 cases received only clear fruit juice 0.5cc/kg). After 30 minutes the five variables of sedation, apprehension and anxiety of separation from parents, mask application and interavenous catheter insertion were observed and documented in check list. Side effects in pre and post- operative periods and recovery time were also observed and analyzed by X2 and t test.Results: 93.4% of group A had sedation score of 3 or more 30 minutes after drinking the drug. Also, 100% of group A were calm when separated from parents and in time of venous cannulation. All of these data showed significant differences between two groups. In group A mean time of sedation initiation was 17.16±2.30 min and at the same time no sedation was observed in group B. Mean recovery time was 16.2±2.3 min in group A and 14.95±2.01 min in group B which showed no significant difference.Conclusion: Oral premedication by using Ketamine 6mg/kg in clear fruit juice can produce good sedation in pediatric patients after 30 min. This tends to lower apprehension and increase cooperation of patients in mask application and catheter insertion and better parental separation, while the same time side effects are least.

Introduction: Hearing loss is the most common sensory defect in humans, affecting approximately 1 in 1000 neonates in which genetic factors are involved in more than 50%. Connexin 26 or GJB2 gene mutations are responsible for half of autosomal recessive non-syndromic hearing losses. The purpose of this study was to determine the GJB2 mutations frequency in autosomal recessive non-syndromic deafness in Kermanshah.Materials & Methods: Among families with hearing loss referring to Genetics Counseling Centers of Kermanhah Welfare Organization, seventy seven families met inclusion criteria for autosomal recessive non-syndromic hearing loss to screen for GJB2 mutations. At first 35delG homozygous samples determined by Allele-Specific PCR were excluded from the study and additional testing was not done. DHPLC analysis of the coding sequence of GJB2 was completed and complemented by direct sequencing in case abnormal elution profiles were observed. Finally, mutations frequencies based on numbers of individuals and chromosomes were calculated. Results: In this study frequency of individuals with 35delG mutation was 14.28 %( 11 of 77 families). Our work showed 23.38% GJB2 mutation rate in deaf samples. In other words, 154 chromosomes were analyzed; Twenty nine chromosomes (18.83%) had a mutation in GJB2 gene. The 35delG frequency was 58.62% among other mutations. The frequency of the 35delG mutation decreases from west to east in Kermanshah Province. After the 35delG mutation, other common mutations were R32H, delE120, IVS1+1G>A. The rate of mutation in exon 1 was 10.34% of allelic mutations in this population. While this mutation is relatively uncommon in other series and has not been previously identified in Iran. Conclusion: On the basis of this investigation, connexin26 gene-related deafness frequency is approximately 23% suggesting that other genes may be involved in hearing loss in Kermanshah Province and further studies are needed to find out these genes. So screening these mutations (35delG, R32H, delE120, IVS1+1G>A) for deaf individuals referring to Genetics Counseling Centers before marriage and or pregnancy is recommended.

Introduction: One of the most common complaints in pregnancy is sleep disturbances which can cause depression. Depression, too, is one of the most common complaints in pregnancy that can affect mother and fetus and even mother and neonate in postpartum period. Therefore this research was accomplished by the objective assessment of relationship between sleep pattern and depression in the third trimester of pregnancy in pregnant mothers who referred to Mashhad Pregnancy Care Centers (MPCC) in 2002.Materials & Methods: This study was a descriptive, analytic and cross sectional one in which 320 of mothers who were in third trimester of pregnancy and referred to MPCC in 2002 were selected. They had inclusion criteria and hadn't trait depression personality. The data were collected by sleep log score, Beck depression inventory and demographic information and pregnancy history. To analyze the data, t-test, ANOVA and linear regression model were employed.Results: The findings showed that the mean of depression scores was 13.30±8.56 and the mean of total sleep scores was 26.05±8.75. The results also showed that there was a significant relationship between depression score and total sleep score (P<0.001) and between depression score and sleep duration, quality (P<0.001), insomnia (P<0.001) and day time alertness (P<0.001).Conclusion: Sleep pattern associated with pregnancy was related to depression. So, there should be established supporting and prenatal care for mental health and preventing the side effects of sleep disturbances and depression on pregnancy, delivery post partum period and health of mothers and neonates.

Introduction: Nosocomial infections affect nearly 10% of hospitalized patients. The majority of nosocomial infections are transmitted by contact, primarily by hands of health care workers. The micro-organisms on the hand can be divided into transient, resident and infectious flora. Transient flora is the main cause of nosocomial infection which acquired primarily by contact and loosely attached to the skin and are easily washed out. This study was done to determine the contamination rate of ICU staff, especially by flora, and its related factors as a first step in controlling and decreasing nosocomial infection in hospitals of Kermanshah. Materials & Methods: In this analytic cross sectional study ,based on census method, ICU staffs hands were sampled in three times during working shifts .In 39 cases, 117 samples were taken and isolated micro-organisms were identified by differential media and divided into transient ,infectious and resident flora.Results: 88.3% of cultured samples showed contamination with transient flora .In the late part of work shift, staff with less than 5 years employment meaningfully showed more contamination (p=0.001). Nurses contamination in the first part of work shift was also statistically significant (p=0.036).Conclusion: Microbial contamination of hands disclosed improper hand hygiene. Hand washing is the single most important, simplest and the least expensive way for preventing infections spreading. Nevertheless in most health care institutions like these, recommended hand washing practices remain low. The reasons include lack of scientific, knowledge unsuitable or lack of hand hygiene facilities, or overcrowding, unfavorable soap, staffs lack of interest , tiredness, and … So, appropriate training and preparing suitable facilities like hand hygiene facilities, are recommended.

Introduction: Burning is one of the main accidents in pediatric medical emergency, which is commonly associated with metabolic, infectious and neurologic complications. The seizure is one of the most important complications in burned patients. This study was done to determine the causes of seizure in burned children hospitalized in Imam Reza. Materials and Methods: This survey was a descriptive study based on available data in which 2212 burned children under 15 years old were selected and studied during 1996 to 2003.Results: 365 patients had seizure attacks of which 86% had happened during the first 48h of admission. Most of the attacks occurred in children younger than 3 years old. Hyponatremia was the most frequent cause of seizure followed by history of previous seizure, febrile seizure, meningitis, head injury, unknown causes, hypoglycemia and hypocalcaemia. Conclusion: It seems that seizure has significant frequency in burned children and it is preventable with respect to predisposing factors. We recommend that hyponatremia is the most important and frequent cause of seizure which should be prevented carefully.