Journal of Kermanshah University of Medical Sciences
Year:2003 | Volume:7 | Issue:3|Papers Count:11

Background & Objectives: Iodine Deficiency Disorder (IDD) is the most common endocrine disorder in the world. It is estimated that about 1.5 billion people are in iodine deficiency state. Many studies have shown the high prevalence of endemic goiter and iodine deficiency in Iran. For control of this health problem salt iodinization is the best accepted strategy in the world.The main objective of this study is to determine the efficacy of iodide salt after 9 years of iodide salt consumption.Materials and methods: In a quasi-experimental study 637 primary school children were examined clinically for goiter based on WHO classification, and their urine was evaluated for iodine per gram creatinine.Results: 94 students (14.7%) including 50 males (15.38%) and 44 females (14.1%) had goiter, with no significant difference between two sexes.The most common grade of goiter was 1a. Compared with a previous report in 1992, there was no significant increase in goiter prevalence but increase in urine iodine was statistically significant (P<0001).Discussion: Despite increase in urine iodine concentration, the rate of goiter is not decreased. It seems that salt iodinization and iodine consumption should be increased.

Background & Objective: Mortality data can be the starting point for many epidemiological surveys. This study was conducted to determine the mortality rates of Kermanshah Province in 1379.Materials and methods: Mortality rate of rural and urban areas were obtained from Kermanshah Health Center and BaghFerdows Cemetery"s archives, respectively. The data of other cities of the province were gathered through health centers through a standard national chart. The chart, which has been delivery by University"s Machine - readable Services (VMS) consists of 17 etiologies of death. Statistical data related to the cemetery of Sonies and other religious minorities were not obtained. The completed forms were checked and coded. The repetitive items were omitted. The needed population size were obtained form the Health Affairs Organization of Kermanshah Province.Results: A total of 9234 dead persons were reported in Kermanshah Province (%41.3 female and %58.5 male). The crude death rate was 5.06 per thousand; median age was 50 +30 year, %67.8 were from urban and %32.2 from rural areas. The five common causes of death were cardiac disease (1.8 per 1000), suicide, poisoning and accidents (0.76 perl 000), poorly defined causes (0.72 per 1000), cancer (0.45 per 1000), and prepartum illnesses (0.41 per 1000).Discussion: Mortality rates in Kermanshah province are higher than the national norms. The mortality rate from five common causes of death is also higher when compared to the national norms. There is a need to study the causes of high mortality rate in kermanshah, especially those due to cardiac disease.

Background & Objectives: Zataria multiflora Boiss is used in traditional medicine to treat gastrointestinal disorders and menorrhagia. The inhibitory effect of this herb on rat uterus contractions has also been reported. The aim of this study was to investigate the effect of Zataria multiflora Boiss hydroalcoholic leaf extract (ZHLE) on isolated rat ileum in presence of some known ileum stimulants.Materials and Methods: Pieces of male and female rat ileum were mounted in an organ bath containing Tyrode solution. Ileum contractions were recorded by means of an isotonic transducer and results were presented in mm or percentage. Ileum was precontracted by KCI, acetylcholine and BaCl2 in presence and absence of certain concentrations of ZHLE.Results: ZHLE significantly reduced the contractions of the ileum precontracted by KCl (60mM), acetylcholine (0.05 mg/ml) and BaCl2 (4mM). The inhibitory effect of ZHLE on KCI-induced contractions was dose dependent. The inhibitory effect of ZLHE on KCI-induced ileum contraction was not affected by propranolol (l mM). The stimulatory effects of these three stimulants at the mentioned concentrations were similar but the inhibitory effect for acetylcholine was stronger than other stimulants.Discussion: ZHLE may induce the inhibitory effect through blockage of the voltage dependent calcium channels in ileum smooth muscle. These results are compatible with those results that are reported in rat uterus. The ineffectiveness of propranolol on ZLHE inhibitory effect indicates that adrenergic agonist substance (s) does not exist in the extract. It seems that there is anticholinergic substance(s) in the extract. The results support the usage of this plant in traditional medicine.

Background& Objective: The prevalence and annual incidence of end stage renal disease among 60 million Iranians is about 15000 and 3175 (53 patients per million), respectively. The first renal transplantation was performed in Shiraz, Iran in 1967. Iran has the most successful renal transplant program in the Middle East region. The renal transplant activity of the country has reached 24 renal transplants per million per year. The number of transplantation centers and transplantations has increased from 2 and 95 in 1986 to 21 and 951 in 1997, respectively. The kidney transplantation (KT) was started in Kermanshah, in 1989. Conflicting Survival rates of KT in Iran and world has been reported and there is no report from Kermanshah. In the present study, patient and graft survival rates of KT are reported.Materials and methods: This study was done on 712 kidney transplant recipients in Kermanshah province and includes all KT recipients from 1989 to 2001. The variables that were analyzed include age, sex, dialysis time, and primary disease. Patient and graft survivals were calculated using Kaplan Meier method. Survival curves were compared with Log rank test. Comparison of data was done with Student's t test, chi square, and Fisher's exact test.Results: Patient survival for recipients with a living unrelated donor (LURD) at 1, 3, and 10 years was 89.4, 82.4, and 61.4 months, respectively, and for recipients with a living related donor (LRD) 100, 97.3, and 72.6 percent. Graft survival for recipients with a living unrelated donor at 1, 3, and 10 years were 85.6, 77.2, and 33.3 respectively, and for recipients with a living related donor 97.4, 92.3 , and 60.6 percent Ranks were higher in recipients with a related donor.(Log rank, P=0.0056).Discussion and Conclusions: Graft and patient survival rates obtained from our study are comparable to the reported results from other units in Iran and some Eastern European countries, higher than most countries of the former Soviet bloc, and less than USA, Japan and Western countries.

Background & Objectives: The epidemiology of suicide plays a significant role in the identification of mental health in the society. The present study was carried out to determine the demographic characteristics and mental state evaluation among victims with suicidal attempt in tabriz (in 2001). Materials and Methods :In this cross - sectional study 301 patients (170 females and 131 males) who attempted suicide and referred to two general hospital centers were selected through convenience sampling and studied by demographic characteristics questionnaire, Structured Clinical Interview and Psychiatric judgment .Results: The highest rate of suicide was found among those aged 17-26 years. 80.4% of victims had a psychiatric disorder. The most common disorders were depressive disorders and adjustment disorder with depressive feature. The most common methods of suicide were drug overdose (71.1%) and poisoning (20.60%). The highest rate of attempted suicide was found in single persons, house wives and unemployed persons.Discussion: Previous and present mental disorders appear to be risk indicators for suicide and persons who attempt suicide tend to be relatively young.

Background and objectives: NICU acquired infections are associated with increased mortality rates, prolonged duration of hospitalization in survivors and increased cost of neonatal health care. The frequency of these infections has increased in recent decades as a result of increased survival of low birth weight infants. In this study, incidence of nosocomial blood stream infection and risk factors were determined.Materials & methods: This analytic descriptive study was carried out in all newborns who admitted for minimum of 3 days in NICU of Razi hospital of kermanshah in the year 1381. Routine blood culture was taken on admission, and in all newborns that had signs and symptoms of sepsis after 48 hours of admission. Nosocomial bloodstream infection was defined as first positive culture occurring > 48 h after admission, or another bacteria grown in the next blood culture. Demographic data, and risk factors such as sex, weight, gestational age, type of delivery, underlying disease and antibiotic sensitivity were collected by information sheet.Results: Incidence of nosocomial bloodstream infection was 8/38 (CI: 5/5% to 11/25%). The rate of infection was higher in very low birth weight infants. There was no statistically significant association between other risk factors (sex, gestational age, type of delivery, underlying disease) and rate of infection. The isolated microorganisms among 30 infected newborns include Enterobocter species (13 cases, 43/3%), klebsiella (10 cases, 33/3%), cytrobacter (6 cases, 20%) and, staphylococcus aurous (1 case, 3/34%). The isolated microorganisms in all 29 newborns with gram negative nosocomial blood stream infection showed resistance to routine NICU antibiotics (gentamycin, amikacin, and ceftizoxim).Discussion: Incidence of infection was the same as in other studies. Very low birth weight newborns had more exposure to nosocomial bloodstream infection in comparison with other newborns. There was resistance to routine antibiotics.

Background& Objectives: Hepatitis C virus is one of the recently discovered viruses that tend to cause chronic liver disease. Hepatitis C is one of the most common types of viral hepatitis, cirrhosis and carcinoma of liver in hemodialysis patients. The most important Risk factors of Hepatitis C in dialysis patients are blood transfusion, duration of dialysis and kidney transplantation .Today, nosocomial transmission of hepatitis C in dialysis centers is an important problem. This study was aimed to determine prevalence and risk factors of hepatitis C among dialysis patients in kermanshah province.Materials and Methods: This descriptive analytic study was done by census sampling among all of the dialysis patients .Data collection was based upon a questionnaire and laboratory experiment. Diagnosis was made by detecting the anti HCV antibody using the third generation Elisa method. The collected data were analyzed by t and X2 tests.Results: The prevalence of HCV was 26.4%.There was significant correlation between the existence of HCV infection and duration of dialysis (P<0.001), blood transfusion (P<0.01), kidney Transplantation (P<0.001), history of surgery (P<0.005). There was no significant correlation between HCV infection and age, sex, history of hepatitis B Vaccination, dentistry procedure, tattooing, and phlebotomy.Discussion: The prevalence of hepatitis C was the same as in other studies abroad but in comparison with community prevalence role of Hemodialysis is significant; the study showed that Hemodialysis is a risk factor for getting Hepatitis C

Background & Objective: Periodic Paralyses are a group of rare disorders that cause temporary episodes of muscle weakness or paralysis. Hypokalemic periodic paralysis usually is transmitted by an autosomal dominant trait with more penetration in men. Hypokalemic periodic paralysis may be secondary to thyrotoxicosis, hyperparathyroidism, drug toxicity and potassium losing states. Sporadic form of disease is rare and appears in male gender.Case report: This case is a 34 years old man with history of periodic paralysis. There was hypokalemia (k=1.98 meq/lit), but other laboratory tests and paraclinical data were normal. First electrocardiogram had ST segment depression, negative T wave and positive U wave with sinus bradycardia (heart rate was 45 beats per minute). ChangesDiscussion: of ST segment, T wave and U wave are common but sinus bradycardia is rare. Limb paralysis and electrocardiogram changes disappeared with ingestion of 6 gram KCL. Therefore in hypokalemic periodic paralysis cardiac arrhythmia can appear as sinus bradycardia that disappears with administration of oral potassium. Cardiac evaluations using ECGs and monitoring should be performed on all hospitalized patients with hypokalemic periodic paralysis.