Journal of Kermanshah University of Medical Sciences
Year:2008 | Volume:12 | Issue:1 (36)|Papers Count:12

Introduction: Although there no agreement about best way for relieving pain in delivery, finding an appropriate method with the lowest pain and drug dose and side effect shoud be considered. The aim of this study is to compare the analgesic efficacy and side effects of Remifentanil and Meperidine as two methods of pain relieving in obstetrics during an uncomplicated labor.Materials and Methods: Forty full term parturient with singleton pregnancy and vertex presentation were randomized to receive either Remifentanil (0.5 mg/kg every 4 min, IV) or Meperidine (50 mg, IM) at the beginning of active labor phase. A visual analog scale (VAS) was used to assess the severity of pain. Also maternal and fetal side effects were assessed.Results: The pain scores were lower in Remifentanil group at 60 min after analgesia (P<0.0001) and during the first stage of labor (P<0.0001) than Meperidine group. The pain scores in second stage of labor were also lower in Remifentanil group (P=0.013). 95% of women rated analgesia as good to excellent in Remifentanil group as compared with 35% in Meperidine group (P<0.0001). Prolonged labor in first stage was rare in the both groups and there were no significant differences between them.Side effects such as sedation, nausea and vomiting and respiratory depression and decreasing hemoglobin oxygen and saturation were rare and no significant differences were seen between groups.Also no significant differences were seen between groups from mode of delivery or neonatal outcomes.Conclusion: The results indicated that for controlling delivery pains Remifentanil is better than Meperidine and side effects were uncommon and adequate continuous monitoring decrease maternal side effects.

Introduction: Based on the reported studies, approximately 90 percent of workplace accident is due to unsafe behaviors and human errors, even though, in a safe work conditions. So, the most important strategy in reducing the rate of these accidents is training workers regarding the safe behaviors. The current study is going to determine the effects of a safety education program on promoting healthy and safe behaviors among workers using the Precede-Proceed Model integrated with both social cognitive and adult learning theories.Materials and Methods: This paper is the report of a randomized clinical trial study done on 191 factory workers of Razi Petrochemical Company Mahshar City. The participants were divided into two groups (96 in case group and 95 in control group). Data was collected using a questionnaire and a checklist. Two months later, the data recollected and was analyzed. Based on distribution of variables, parametric (t-test, paired t-test) or nonparametric (Mann Whitney, Wilcoxon) tests were utilized to analyzethe data.Results: The result indicated that the mean scores of knowledge, attitude and behaviors of safe behaviors in case group increased statistically significant and the observed difference in control group was not significant. The result also indicated that unsafe behaviors in the case group decreased, following the educational intervention. The difference, again, was not statistically significant in the control group.Conclusion: The results showed that application of mentioned integrated models has an acceptable and positive influence on promoting safe behaviors of workers working in Mahshar Company. It is, therefore, recommended that some educational programs be useful for other and similar industries.

Introduction: Abusing performance-enhancing and illicit drugs among young adults remains an issue of concern in today’s society. Performance-enhancing drug abuse has bad effects on all fields such as health, economic and culture of community. Performance-enhancing drug abuse relatively is common in Iran, particularly in Kermanshah. This article shows the results of research that was conducted to define the effect of education on percentage of performance-enhancing drug abuse by bodybuilders.Materials & Methods: Sample size in this quasi-experimental study was equal to 360 people, but we invited over 600 body building club’s members to participate in educational programs. Before starting the program, 369 people and a month afterward 312 athletics completed Self-administered questionnaires-contained; demographic information, using drug (yes/no, what, why). To determine the effects of education on performance-enhancing drug abuse rate among bodybuilders, the percentage of performance-enhancing drug abusers before and after intervention was campared. Lastly, the Data gathered were analyzed by McNemar test.Results: The results of this study showed that 74.5% cases were less than 25 years. According to the results of this research, there was statistically significant differences between percentage of performance-enhancing drug abused bodybuilders before and after intervention (before=50.14%, after=33.44%, p=0.000). Educational effects in younger men and in persons with low literacy were significantly higher than the elders and high literacy persons. In addition, most athletes believed that education about correct nutrition and knowing safe supplements are the best way to prevent performance-enhancing drug abuse.Conclusion: The results of this study indicated that educational interventions can significantly reduce performance-enhancing drug consumption and this effect among younger people with low literacy is much higher. Therefore, sport medicine physicians can play a variety of important roles as educators, counselors, and support systems on young athletes, regarding the effects of substance abuse.

Introduction: During the thirty years ago noise pollution increased quickly in the urbane communities that motorcycles are chief sources of noise. The objective of this study is reduction of noise emitted from motorcycle exhaust, applying engineering design.Materials and Methods: In this pre-experimental study, current condition of noise emitted from motorcycle exhaust and physical parameters of exhaust gas is determined and measured again after planning. In this study JIS D 1616 and SAE J1287 are used for noise measurement and JIS B 8006 and JIS B 8007 respectively for pressure and temperature measurement of exhausted gas from Honda CG125 type of motorcycle. For noise, temperature and pressure measurement of exhausted gas, cell 490 sound level meters, ordinary mercury thermometer, pitot tube and inclined manometer were used respectively.Results: In this motorcycle, in the natural rpm (3000 rpm), Noise level emitted from current silencer was 97.74 dBC and in type 2 reduced to 94.54 dBc. In the natural rpm (3000 rpm) insertion loss of current silencer in 100-400 HZ was equal to 10.94 dB and by engineering planning this parameter reached to 14.22 dB.Conclusion: For reduction of noise emitted from motorcycle exhaust it is better to use reflective and simple silencer

Introduction: In major b-thalassemia impaired biosynthesis of beta hemoglobin leads to accumulation of unpaired alpha hemoglobin chain. An iron overload generates oxygen-free radicals which ultimately lead to tissue injury. The aim of this investigation was to evaluate serum antioxidants in patients with major b-thalassemia and those with minor thalassemia in comparison with respective age and sex matched control groups.Materials & Methods: Patients with major b-thalassemia or individuals with minor thalassemia (Age range: 2-12 years and 29-46 years, respectively; n=20 each) and 20 age and sex matched control subjects were recruited. Serum glutathione (GSH), superoxide dismutase and catalase (CAT) were determined spectrophotometrically. Data were analysed by t-test.Results: Glutathione levels were markedly lower in patients with b-thalassemia major than in the controls (P<0.05) whilst no differences were seen in either in the activities of catalase or superoxide dismutase. On the contrary, no differences were observed in individuals with minor thalassemia .When patients with major b-thalassemia and individuals with minor thalassemia were compared a marked reduction in GSH levels and increased in CAT activity were noted in the patient group (P<0.05).Conclusion: The data implies disturbance in antioxidant system in patients with major b-thalassemia as measured by a marked reduction of serum glutathione as the first line of defence against free radical attacks and increased in the activity of CAT. This condition eventually leads to cellular tissue damage.Antioxidant therapy may, therefore, prove useful in protecting against tissue damage.

Introduction: The diagnosis of symptoms and the estimation of cancer risk in individuals are of great interest for research teams. Several methods developed for estimation of the risk of cancer in the individuals exposed to risk. Because of its capability to illustrate the correlation between genotype and phenotype, the Kin-Cohort Method has become a method of choice for many researchers. This study aims to employ a modified Piecewise Weibull Model for estimation of penterance in patients with breast cancer characterized by BRCA1 and BRCA2 gene mutations carriers.Materials & Methods: The research follows a descriptive and analytical method. A set of data was simulated to resemble the true values. The simulated data set was analyzed using both Piecewise Exponential and Piecewise Weibull models. EM algorithm and bootstrap sampling were employed for maximization. Akaike’s criterion was used to compare the two methods, and graphs of the Penetrance values were plotted to show the differences. To estimate the penetrance of BRCA1/2 gene mutations, data was collected from the patients voluntarily referred to the Department of Medical Genetics and the Department of Cancer and Cytological Genetics of Medical School of Tehran University of Medical Sciences.Results: Results of the simulated data showed that the estimates of cancer penetrance in the carriers and non-carriers in all age groups were closer to the default values in the Weibull model in comparison with the exponential model. The differences in Akaike’s criterion, 311 and 2753 for the non-carriers and carriers respectively in both models, showed a significant difference between the Exponential and Weibull models. Estimated penetrance for the age groups below and over 50 among BRCA1/2 carriers for breast cancer was 31.9% and 46.2% respectively.Conclusion: The knowledge of penetrance is important in genetic counseling. Therefore methods capable of generating most accurate estimations are preferred. Results of the simulation revealed that the piecewise Weibull model is preferred for the estimation of Penetrance in Cancer Patients. The low value of the estimated penetrance in this study can be attributed to the rare mutation in Iranian population. Establishment and use of a Kin-Cohort gene databank is proposed as a solution for preparation of screening programs and estimation of the penetrance to help reduce the risk of cancer.

Introduction: In electroplating processes, hexavalent chromium mist is emitted in air. Hexavalent chromium mist can cause lung cancer and nasal septum in workers. As Permissible Exposure Limit (PEL) of hexavalent chromium is low (0.5 mg/m3) and it is used in various industries, evaluation of workers exposure to hexavalent chromium is very important. However, hexavalent chromium is relatively unstable and it can be reduced to trivalent chromium during sampling, storage, and extraction. So, factors influencing determination of Cr (VI) must be evaluated. In this study, influence of some factors such as sampling time, storage time, type of filter, and storage temperature on reduction of Cr (VI) were investigated.Materials and Methods: In this study, based on experimental design, 168 hexavalent chromium mist samples were collected and analyzed according to the NIOSH 7600 method. All samples were collected by two types of filters (PVC, BQFF) at different sampling durations (30, 180, 480 min) and different storage times (0, 3, 24, 72 hours). Some samples were analyzed immediately after sampling and some of them were stored at 3, 24, and 72 hours at two different temperatures (20-25oC, 4oC).Results: Results showed that, Cr (VI) concentration was decreased with increasing the sampling time (Pvalue<0.001), also, Cr (VI) concentration was decreased gradually with increasing of storage duration (Pvalue< 0.001). Hexavalent chromium mean concentration in BQFF filter was more than PVC filter (Pvalue<0.001). Also, storage temperatures had no effect on reduction of Cr (VI) (Pvalue>0.05) Conclusion: Because of acidic and instability of Cr (VI) mist air, by increasing sampling time, Cr (VI) is reduced. Also, acidic media of filter at sample storage can cause possible reaction of polymeric and oligomer materials of filter media with Cr (VI), in which, with increasing storage time, Cr (VI) can be reduced on filters. On the whole, at starting sampling times (30 min) BQFF is more efficient than PVC for collection of Cr (VI). Based on the obtained results, storage conditions of samples had no effect on Cr (VI) reduction.

Introduction: Motorcycling is a risky activity and motorcyclists are vulnerable to road accidents. The behavior of motorcyclists is a significant factor of accident. Unfortunately there is little information regarding social and mental characteristics of motorcyclists which lead to the accident. The purpose of this study was to gain an in-depth qualitative understanding of reasons for riding a motorcycle and taking risky behaviors in Iranian motorcyclists.Materials and Methods: In this Study qualitative study in which sampling was derived from diverse situations. Data were collected in diverse times and places of Tehran such as hospitals, house, street, and police station. Focus groups and in-depth interviews were conducted with 22 motorcyclists, pillion passengers and police. Interview data were supplemented with observations and police report.Interviews were of semi structure and nonstructure forms and were done from March 2007 to January 2007. Data were analyzed using content analysis.Results: The results revealed four major themes for choosing to ride a motorcycle: I) using a fast and convenient vehicle to get through traffic, II) occupational necessities, III) emotional needs, IV) easy for foul playing and breakaway.Conclusion: These findings provide evidence that there are many different reasons that motivate people to ride a motorcycle and these in turn affect preventing strategies.

Introduction: Treatment of Wastewater due to product and consumption of material cleaning with special physicochemical characteristics is difficult, and therefore can cause significant environmental problems such as eutrification, toxicity, algae bloom and etc. To stop these consequences, assessing the quality characteristics of this wastewaters is necessary. To investigate about the appropriate method of treatment, Paksan Factory producing 30 percent of Iran detergents was selected.Materials& Methods: This study was a descriptive-cross-sectional one in which 30 wastewater composite samples24hr (obtained by combining portions of 720 grab samples) were taken during a five month period. The samples were properly preserved with acid and kept under 4oC during experimentation and transported to laboratory. The chemical characteristics were determined. Data analyzed using descriptive statistics.Results: The results of the samples showed that the wastewater temperature was 40.84±12.31 and the pH was 10.56±2.96. It also showed that the concentrations of the organic loading of wastewater were very high, expressed as COD, ranging from 6254-13040 mg/l, concentration of BOD was 2459-3200 mg/l and concentration of MABS ranging from 245-1120 mg/l. The results indicated that the BOD5/COD ratio was 0.34±0.09 and the mean of phosphorus was 88.13 mg/l.Conclusion: temperature and pH in wastewater of this factory have ringed with very changes and organic load was high. In most of samples BOD5/COD ratio was proper for biological treatment but in the samples that were not proper for biological treatment this problem would be solved with combination treatment of industrial wastewater and domestic one This wastewater has high concentration of foaming that prohibit of oxygen infiltration in wastewater and nonbiodgredable material. These results indicated that the wastewater is not easily subjected to conventional system of biological treatment; therefore such wastewater can cause some environmental problems.

Introduction: The pectoralis major flap is the best flap for head and neck defects. This flap has both a vascular pedicle and some disadvantages such as deformity, needing tunneling, clavicular f.x and shortening after the tunneling.Case Presentation: The patient was a 56 years old man with large face defect from child hood. The patient had two surgical failures in her history. External pectoralis major flap, was used since the patient had large defect with far distance between donor and recipient site.Conclusion: Pectoralis major flap was cut after 3 weeks and it continues its work with no problem, so this technique is a new method for large and more distant defects. This method has a little morbidity with excellent cosmetic result.